FORM NO.
COURSE APPLIED
STUDENT NAME
GENDER :
STUDENT TYPE :
FATHER'S / HUSBAND NAME
MOTHER'S NAME
NAME OF COLLEGE
AADHAR
CASTE
D.O.B
CATEGORY :
RELIGION
MOBILE NO.
SUB CATEGORY :
ABC ID :
NATIONALITY
INDIAN
ENROLLMENT NO. :
Roll No. :
SUBJECT/PAPER OPTED
DETAILS OF PREVIOUS YEAR EXAMINATION
PERMANENT ADDRESS:
,
,
MAILING ADDRESS:
,
,
(SIGNATURE OF THE CANDIDATE)
CERTIFICATE BY THE DEAN /HOD/ PRINCIPAL
DATE
SIGNATURE OF OFFICE ASSISTANT
(DEAN /HOD/ PRINCIPAL SIGNATURE WITH SEAL)