Online Registration Form

Name:*

Father's Name:*

Mobile No:*

Email ID:*

Correspondence Address:*

Pincode:*

Permanent Address:*

Pincode:*

Course Title:*

Duration:*

From:*

To:*

Photo Upload:*

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Contact Details

Std Code:

Phone No:

Alternative Mobile no:

Alternative Email Id:

Date Of Birth:*

Blood Group:*

Gender:*

Nationality:*
IndianForeignNationals

UID(Aadhar No):*

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) *

Examination	Board/university	% of Marks	Grade	Year Of Passing	Certificate Upload
10th STD.					choose a file
12th STD.					choose a file
Degree/Diploma					choose a file
Other Courses					choose a file

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.

Date:*

Signature of Applicant:*

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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.

Registration Cum Admission Form

Contact Details