Student Information

Student Information

Name of the Course

Name of the Course

Full Time
Part Time
Regular
Lateral Entry

Name of Candidate (as entered in class X certifficate)

Tick the Appropriate () Boxes :-

Gender

Male
Female
Other

Category

SC  
ST  
OBC   
Other   

Would you like to apply for Bank Loan

Yes   
No   

Date of Birth

Place of Birth

Family Details :-

Father's Name

Qualification

Occupation

Annual Income

Mobile No.

Mother's Name

Qualification

Occupation

Annual Income

Mobile No.

Nationality

Country of Citizenship

Mailing Address

Permanent Address

Mobile Number(self)

Email

(Inform the change in number if any to the authorities)

Mode of Stay

Day Scholar
Hostel
Transport

Eligibility

Pass
Result Awaited
Reappear

Rank in the qualifying Entrance Test, If any

Previous Exam Passed

Subjects Studied

Marks Obtd.

%age

Session

Roll No.

Board University

Name of School/ College

Matric

10+2

Graduate

Post Graduate

Any Other