Registration Form

Course Applied for:

Name of Student:

Father's / MOther's Name:

Date of Birth:

Sex:

Male Female

Category:

Gen OBC SC ST

EDUCATIONAL DETAILS

Hostel:

Yes No

Category of Hostel Room:

2 Seater 3 Seater 4 Seater

Postal Address:

District:

State:

Place:

MobileNo.:

Guardian's Contact No.:

Date:

Email ID:

Applicant's photo (optional):