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Personal Data:
 
  • Name of the Applicant
    (as shown in the matriculation certificate)
    		•   
       
  • Phone Number
    		•   
       
  • Email
    		•     
       
  • Father's Name
    		•   
       
  • Father's Occupation
    		•   
       
  • Mother's Name
    		•   
       
  • Mother's Occupation
    		•   
       
  • Date of Birth
    		•   
       
  • Age
    		•   
       
  • Sex
    		•
       
  • Blood Group
    •    
  • Your Annual Family Income
    		•
       
  • Hostel Required
    		•
     
     
     
    Academic Profile:
     
    Examination Board/University School/College Year of Passing % of Marks
             
             
             
             
     
     
    Full Time Work Experience (if any):
     
    Company Duration Designation/Job Profile
         
         
     
     
     
    Extra Curricular Activities, Hobbies & Interests:
        (Indicate achievement & awards if any)
     
     
     
     
    Address, Telephone No., & E-Mail ID:
     
    Address for Correspondance Permanent Address
           
    Guardian's Contact No.   Parent's Contact No.  
           
    Address   Address  
           
    Pin Code   Pin Code  
           
    Telephone   Telephone  
           
    Email   Email  
     
     

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