Online Registration Form

Online Registration

Personal Details Field marked with * are mandatory. Please pay Rs. 500/- at next step for registration charges.

Name in full (BLOCK LETTERS)*

Gender*

Blood Group

Email ID*

Father's Name*

Email ID*

Mother's Name*

Email ID*

Family Annual Income*

Mobile No*

Religion*

Aadhaar No

Identification Mark

Mobile*

Emergency Contact Number*

Date of Birth*

Category*

Family ID

Occupation*

Permanent Address*

District*

State*

Pin*

Correspondence Address

District

State

Pin*

Academic Qualification

Details	10th	12th	Diploma/Graduation
Roll No.
Passing Year
Subject
Name of School/College/University
Board
Marks Obtained
Maximum Marks
Percentage
CGPA

Details of Entrance Examination

Is there any gap in your career?

Entrance Examination Details

Name of Local Guardian

Hostel Required?

Transportation Required?

Gap Reason

Roll No

Address

Room Type

Bus Stop

Rank/Percentile

Phone

Mobile No. link with Aadhar

Mobile No. link with Family ID

Student's Bank Details:

Account Holder Name

Bank Name

Account Number

IFSC Code

Upload the following documents

Image

Photo*

Upload

Documents

10th Mark sheet *

Upload

12th Mark sheet

Upload

12th School Passing Certificate

Upload

Migration Certificate

Upload

Character Certificate

Upload

Address proof (Aadhar card/Ration card/Voter card) *

Upload