Online Registration Form - Diploma

Examination Centre:

Course Title:

Name:*

Father's Name:*

Mobile No:*

Email ID:*

Correspondence Address:*

Pincode:*

Permanent Address:*

Pincode:*

Course Title:*

Photo Upload:*

choose a file

Contact Details

Std Code:

Phone No:*

Alternative Mobile no:

Email Id:*

Date Of Birth:*

Gender:*

Nationality:*
IndianForeignNationals

Caste/Category:*
SCSTOBCGeneral

Minority:*
YesNo

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) *

10th STD

Place:*

Date:*

Signature of Applicant: (PNG/JPEG)*

choose a file

Payment Reference No::*(Perform Online Payment and Give the Reference No Here:)

Online Payment

Note: Applicants belongs to SC/ST category are required to attach two sets of above document.
Photo and Signature limit is 80-100 KB
Registration Fees: SC/ST: 250 ; OBC/OC: 500

Registration Cum Admission Form – Diploma

Contact Details