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...