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APPLICATION FORM FOR ADMISSION/REGISTRATION
July 2017
Fields marked with * are mandatory
Course Details
Session:
Qualifying Exam:
*
---------Select--------
DCA
GRADUATION
HSSC
PGDCA
Course Name:
*
---Select Course---
Class Name:
*
Select Class
Personal Information
Student Name(As per 10+2 Marksheet):
*
Medium:
*
Hindi
English
Gender:
*
Male
Female
Maritial Status:
*
Married
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F/H Name:
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Mother's Name:
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Category:
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General
OBC
SC
ST
Date of Birth(YYYY/MM/DD):
*
Nationality:
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Indian
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specify Country
Religion:
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Hindu
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Handicapped:
Yes
No
Adhar Number:
*
Permanent Address of Student:
Address:
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State:
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District:
*
--Select Dist.--
City:
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PinCode:
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E-Mail ID:
Tel/Mobile No:
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Educational Information
Particulars of the qualifying examination:
Qualifying Exam
*
Board/University Name
*
Year of Passing
*
Maximum Marks
*
Obtain Marks
*
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