Application For UG / PG Programme 2021-22

Choose The College

Course

B.Sc Course

Name of the Student *

Father name *

Address for Communication *

Pincode *

Phone Number *

Permanent address

Pincode

Phone Number

Gender *

Religion *

Community *

Nationality *

Date of birth *

Age *

Mother Tongue

Blood Group

Extra Curricular activities: Sports/ Cultural/ NSS/NCC/ other specify

Educational Qualification

Sl.No Course Month & Year Board / University Name of the Institution Percentage
1 SSLC *
2 HSC
3

Marks Scored

Subject Maximum Marks Obtained Marks
TOTAL 0.00 0.00

Photo *

Signature of the Candidate *

Date *

Place *

Email *

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