Admission Form : * indicates mandatory Field
Course Code : Course Name :
Personal Information
Full Name * :
Father's Name * :
Mother's Name * :
Date of Birth : Category :
Religion * : Sex :
Nationality : Physically Handicapped :
Full Postal Address :
Permanent Address *:
Mother Tongue : Qualification :
Aadhar Card No : Mobile No * :
Educational Information
School/College/University Board/University Exam /Course Year Score(Division) % of Marks
Declaration : I have read all the rules and regulation of the institute and admission to the course applied for. I declare that the above information is true and correct to my knowledge and belief and I fully understand that my admission will Stan cancelled if any information by me is found to be false or twisted.