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App No : 2020-0551 Date:13/04/21
ADMISSION FORM
APPLICANT DETAILS
Course Applied for   : 
Applicant's Name   : 
Gender   : 
Blood Group   : 
Date of Birth   : 
Age   : 
Affix passport size photo of the student
Mother Tongue   : 
Caste   : 
Community   : 
Religion   : 
Physically Challenged   : 
PARENT/GAURDIAN DETAILS
Father's Name  : 
Father's Occupation  : 
Mother's Name  : 
Mother's Occupation  : 
Gaurdian's Name  : 
Gaurdian's Occupation  : 
Father/Guardian's Annual Income  : ₹





CONTACT DETAILS
Nationality  : 
Native Place  : 
Phone  : 
Email  : 
Permanent Address  :


 
Communication Address  :


 
State  : 
ACADEMIC DETAILS - SECTION A
Whether availing First Graduate Concession. If yes, certificate must be enclosed(Goverment Quota Candidates only). 
11th Standard
Board  : 
School Name  : 
Subjects Month/Year of Passing Marks Obtained Maximum Marks

Total  :   Average  : 



ACADEMIC DETAILS - SECTION B
12th Standard
Board  : 
School Name  : 
Subjects Month/Year of Passing Marks Obtained Maximum Marks

Total  :   Average  : 
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