PERSONAL DETAILS

Full Name*
(as per HSLC record)

Date of Birth *

Gender*

Male

Female

Category*

Tribe/*
Community

Religion

Marital Status

Married

Single

Nationality*

Blood Group

Identification Mark*

Phone No.*

E-mail

If Physically Challenged, Explain Briefly

ADDRESS

Permanent Address*

Pin code

Country*

State*

City

Mailing Address

Check if mailing address is same

Pin code

Country*

State*

City

PARENT'S DETAILS

Father’s Name*

Phone No.*

Mother’s Name*

Phone No.*

ACADEMIC DETAILS

Examinations	School/College	Board/University	State	Roll No.	Year of passing	%
HSLC
HSSLC
BA/BSC

ACCOMMODATION

Accommodation*

Hosteler

Day-Scholar

Do you have any sickness that demands regular medical attention?

Yes

Do you have any dietary concerns/ restriction?

Yes

Guardian’s Name

Phone No.

GUARDIAN’S ADDRESS

Pin code

Country*

State*

City

STUDENT'S DECLARATION

Student's Declaration

I have read the rules and regulations of the College, I will conscientiously abide by them. In the event of violation, I will accept the penalty imposed by the college. The information and documents I have provided are true to the best of my knowledge. However, should anything be proven false/fake at any stage of my admission or stay in the college, I duly agree that my admission will stand cancelled.

I agree with the Terms and Conditions.

Registration Form

Preview image

PERSONAL DETAILS

ADDRESS

PARENT'S DETAILS

ACADEMIC DETAILS

ACCOMMODATION

GUARDIAN’S ADDRESS

STUDENT'S DECLARATION

Student's Declaration