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Application Form
All Fields are mandatory
1] Name:  
2] Father Name:  
3] Mother Name:  
4] Date of Birth:
5] Caste:  
6] Nationality:  
7] Qualification:
upload your Passport size image less than 1MB
Sl. No. Description Year of Passing University % Certificate[marks card number]
1
2
3
8] Permanent Address:   [250 characters only]
9] Temporary Address:   [250 characters only]
10] Email Id:    
11] Contact No:  
12] Heighest Qualification:  
13] Bank Details:
1) Bank Name:  
2) Branch Code:  
3) Paid Amount:  
4) Date:
5) Challan No/id/: (Please scan & upload the Transaction Challan less than 1MB)
14] Select the Location: State:   District  
15]
16] Digital Signature: less than 1MB