Admission Form


Personal Information Section
Last Name First Name Middle Name
Name of Student * * *
Name on 10th Certificate
Father's/Husbands Name
Mother's Maiden Name
Date of Birth Gender: Male Female
Place of Birth Blood Group
Religion Citizen of
Address for Correspondence
State District Tahsil:City/Town/Village
House No,Street/Area Pincode
Permanent Address
State District Tahsil:City/Town/Village
House No,Street/Area Pincode
Contact Details
Phone: STD Code Phone No.
Mobile No * Email Id *
Legal Reservation Information
Domicile of State Category
Caste Sub-Caste
Social Reservation
Ex Serviceman/Ward of Ex Serviceman Member of Project Affected Family
Active Serviceman /Ward of Active serviceman Member of Earthquake Affected Family
Freedom Fighter / Ward of Freedom Fighter Member of Flood / Farming Affected Family
Ward of Primary Teacher Resident of Tribal Area
Ward of Secondary Teacher Kashmir Migrant
Deserted / Divorced / Widowed Women None


Education Details
Last Attended College Year Roll No

Name of Examination Name of Board/University Name of School/College Date of Passing Examination Seat(Last) No. Grade/Total Marks Obtained Out of
10th
12th
Diploma


Guardian Information
Guardian's Name
Occupation of the Guardian Annual Income of the Guardian (Rs.)
Relationship of Guardian with applicant Phone No.


Other Information
Mother Tongue
Employement : Employeed Unemployeed
Want to Join NCC/NSS ? Yes No
Would you like to apply for Hostel ? Yes No
Hobbies, Proficiency and Other Interest :
Games and sports participation :
Personal Identification Marks :


           
 
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