LAST NAME FIRST NAME MIDDLE NAME
STUDENT NAME
FATHER NAME
MOTHER NAME
GENDER : DATE OF BIRTH :
PRESENT ADDRESS
CONTACT DETAILS
PERMANENT ADDRESS
DEGREE INSTITUTE UNIVERSITY FROM TO % MARKS
S.S.C. 10th
H.S.C. 12th
GRADUATION
POST GRADUATION
EDUCATION OCCUPATION ANNUAL INCOME IN RS. CONTACT NO.
FATHER
MOTHER
I hereby declare that all the particulars stated in the application are true to the best of my knowledge and belief. I agree to abide by the rules and regulations of the Institute and also the decision of the University Authorty regarding my admission.
I Father / Guardian of undertake to abide by the rules and regulations of the Institute.
