01. Course Applied for |
Course Choice I : |
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Course Choice II : |
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Course Choice III : |
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02. Personal Details |
Candidate's Name : |
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Father's Name : |
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Mother's Name : |
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Father's Occupation : |
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Annual Income (Rs.) : |
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DOB : |
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Candidate E-Mail ID : |
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Aadhaar No. : |
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Attached ID : |
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Permanent Address : |
Correspondance Address : |
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Gender |
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Category1 |
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Category2 |
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Nationality |
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Religion |
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Candidate's Mobile No. |
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Parent's Mobile No. |
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Payment Mode |
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Challan/Transctaion ID |
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Amount |
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Admission Number |
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![Please Fix a Passport Size Photograph](../) |
![Please Fix a Passport Size Photograph](../) |
Signature of Candidate |
(Photograph & Signature should be attested by the Head of Institution with Seal) |
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