COURSE APPLIED FOR (select the course)





Image (JPG/PNG) size 1MB Max.

S T U D E N T

1. Student's Name
(As it appears in Birth Certificate)*
2. Date of Birth (mm-dd-yyyy)*
3. Age (As on 31st March 2019)*
4. Place Of Birth* 5. Gender*
6. Admission requested for 7. Name of Examination/Board*
8. School Last Attended* 9.
10. Class Last Attended*
11. T.C No. (If Any) 12. Blood Group*
13. Religion* 14. Denomination (If Christians)
15. Mother Tongue* 16. Nationality*
17. Category* 18. Tribe Name (If S.T.)
19. Aadhaar Card No. 20. Bank Account No.
21. Bank Name 22. Bank IFSC

F A T H E R

1. Name
(As it appears in Identity Proof)*
2. School attended (name)* Where*
3. College attended (name)* Where*
4. Educational Qualification* 5. Occupation*
6. Designation* 7. Department*
8. Name of Establishment/Institution/Company*
9. Aadhaar Card No.

M O T H E R

1. Name
(As it appears in Identity Proof)*
2. School attended (name)* Where*
3. College attended (name)* Where*
4. Educational Qualification* 5. Occupation*
6. Designation* 7. Department*
8. Name of Establishment/Institution/Company*
9. Aadhaar Card No.

C O N T A C T

Present Address

1. Line 1 (House / Plot No. etc.)*
2. Line 2 (Street / Colony/ Area / PO)
3. City * 4. Pin*
5. State* 6. Country*

Permanent Address (If different from present address) Copy

1. Line 1 (House / Plot No. etc.)
2. Line 2 (Street / Colony/ Area / PO)
3. City 4. Pin
5. State 6. Country

Phone Number And Email Address :

1. Phone (Res) 2. Phone (Off)
3. Mobile *(1)
(For SMS Alert)
4. Mobile (2)
5. Email Id *(1) 6. Email Id (2)

AVERAGES FOR STD-X (Attach photocopy of the progress report/mark sheet):

TERM English I & II (Avg.)
1st Term
2nd Term
3rd Term
TOTAL
AVERAGES
Upload Previous class Marksheet(file must be less than 100kb! with JPEG,PNG,JPG,PDF)*

SPECIAL NOTE REGARDING DOCUMENTS (Hardcopy) TO BE SUBMITTED IN THE OFFICE:

VERY IMPORTANT:

DECLARATION:

 I Agree.