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Personal Details

Please complete the fields highlighted in Red (*)

First Name*

Middle Name*

Gender

Last Name*

Place of Birth*

Address for Correspondence*  

Mobile No. *    

Father's Occupation

City

State

Pin Code*

Email id *

Father's No.

Academic Qualification:

CLASS
Class XII (10+2) / Equivalent
YEAR OF PASSING
OVERALL PERCENTAGE (%)
P.C.M. PERCENTAGE (%)
BOARD / UNIVERSITY
Others (Diploma  in Engg / B.Sc / B.E. / B.Tech)

DECLARATION BY THE APPLICANT

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I hereby declare that all the information furnished in this application is true & correct to the best of my knowledge & belief. The original certificate will be produced for verification at the time of admission.

I Agree *

Thank You ! for filling up the form

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