Form Fillup For General Course

Monday, 25 Jun 2018

PERSONAL PART

Name

Date of Birth

Attach Your Passport Size Photo

Not more than 100kb

Not more than 100kb

Upload Student Signature

Nationality

Religion

Minority

Gender

Caste

Sub Caste

Physically Handicapped

Contact No.

Whether 1st Generation Learner

Are you from family of bidi worker?

Whether BPL ?

BPL No

Father's Name

Monthly Family Income

Father's Qualification

Address of the candidate:(PERMANENT)

Whether Staying at

Local Address

Address For Correspondance:

Police Station (P.S.)

Mother's Name

Mother's Qualification

Guardian's Name

Guardian's Occupation

Relation with Guardian

Guardian's Contact No.

Marital Status

Spouse Name

ACADEMIC PART

H.S/Equivalent Roll & No./Index No.

Year of Passing

Name of the Council/Board

Name of the School

Statement of marks obtained in the H.S./Equivalent Examination

Please Select Subject	Marks Obtained		Full Marks
EnglishCompulsory






Total Marks		Best Five

APPLICATION PART

Applicant may choose Elective Subject(s) as per his/her choice. But finally the said subject(s) will be offered to him/her on availability or eligibility at the time of admission.

Please confirm Date of Birth then submit your Application Form.