(Please Fill The Details Using Block letters And Use * Mark)
Name:*
Father's Name:*
Mobile No:*
Email ID:*
Correspondence Address:*
Pincode:*
Permanent Address:*
Course Title:*
Duration:*
From:*
To:*
Photo Upload:* choose a file
Std Code:
Phone No:
Alternative Mobile no:
Alternative Email Id:
Date Of Birth:*
Blood Group:*
Gender:* —Please choose an option—MaleFemaleOther
Nationality:* IndianForeignNationals
UID(Aadhar No):*
Caste/Category:* SCSTOBCGeneral
Minority:* YesNo
if Yes():* MuslimChristianBuddhistParsiJainNone
Any Physical Disability:* YesNo
If Yes Specify:
Occupation of father:*
Income per Annum:*
Details of Educational Qualification: (Attach the Attested Copies of Certificates For Verification) *
Examination
Board/university
% of Marks
Grade
Year Of Passing
Certificate Upload
10th STD.
choose a file
12th STD.
Degree/Diploma
Other Courses
Experience, If Any:
I do hereby declare that the information given in this application is true and complete to the best of my knowledge and belief.
Place:*
Date:*
Signature of Applicant:* choose a file
Payment Reference No:*
Online Payment
Note: It is mandatory to attach self attested photocopies of SSC certicate marksheet, aadhar card, latest qualification and caste certificate as applicable.
Applicants belongs to SC/ST category are required to attach two sets of above document.
