Student's name:

Father's name:

Date Of Birth:

Gender: Select Male Female

Educational Qualification:

Religion:

Community: Select General OBC DNC SC ST

Languages Known:

Courses To Be Applied For:

Contact Address:

Pin:

Permenant Address:

Pin:

Mobile:

Mail Id:

I hereby declare that the above given particulars are true to best of my knowledge and if any wrong I will be responsible by all means to clear it, otherwise I maybe charged any legal action. Also I know that whether I classes or not, my paid fees will not be refunded me or transferred anymore.