Application Form

Please Submit the below Details, our Admin will contact you

    Personal Details
    Name Of the Student:(required)
    Father’s Name:(required)   Mother’s Name:(required)
    Nationality:    Mother Tongue:
    Sub Caste/Castes:    Religion:
    Date of Birth:(required)   
    Gender:(required)MaleFemaleUnspecified
      
    Physically Handicapped
    Total VH % (required):

    Should be greater than or equal to 40%

         		  
      
    Mobile Number:(required)   Email ID:
    Aadhar Card No. (UID)(required) :   
    Present Address
    H.No :    Street
    Post&Village    State :
    District   Mandal
    Permanent Address
    H.No :    Street
    Post&Village    State :
    District    Mandal
    Parents Details
    Mobile Number of Parent/Guardian: (required)    Email-ID:
    Occupation:    Vehicle :
    Farm Land/House:    Educational Level:
    Congenial Diseases if any:
    Upload Latest Passport Size Photo(.jpg/.png/.gif) (required):   

    File size should not be greater-than 50kb...