Application No.

Name of Candidate

Name of Parent/Gaurdian

Address of Parent/Gaurdian

Post

District

State Pin

Email Id of parent (if any) Phone

Address To Which Communications Are To Be Sent

Post

District

State Pin

Email Id of Student (if any) Phone No. Of Student

Age And Date of Birth

Sex

Nationality Religion Caste

Whether Belongs To SC ST OEC OBC OTHER

School/College Last Studied Year Of Study

Board/University

No. of Appearance For Passing The Qualifying Examination

Annual Income Of Parent

Occupation Of Parent/Guardian

Register No. of Qualifying Examination Percentage of Total Marks

Course For Which Admission Is Sought First Choice Second Choice Third Choice