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Choice of Branch *
Type of Admission * Single Window SystemManagement

Biographic Information

Full Name *
Name of the Father/Guardian*

Mother Name *
Place of birth *

Gender * MaleFemale
Date of Birth *

Religion *
SC/ST/BC/MBC/OC*

Parents Occupation *
Nationality*

Annual Income *
Blood Group *

Permanent Communication Details

Address *

City*

State *
Country *

Phone *
Email *

Qualifying Examination Details

Exam Passed *
Name of Institution *

Board of Examination *
Year of Passing *

% of Marks Scored
% Marks Scored in Physics

% Marks Scored in Chemistry
% Marks Scored in Mathematics

Medium of Instruction *

Other Details

Whether Hostel Accommodation required *
Do you Require Bus Facilit *

Declaration By The Applicant

I hereby Certify That the Information Given in this Application Form is Complete and Accurate and I understand that the Submission of inaccurate information will entail no admission or termination of enrollment. I shall abide by the rules and regulations Laid Down by the Institutions from time to Time

Name of the Student
Name of the Parent

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