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1 Name
2 Father's Name
3 Date of Birth
4 Institution Last Attended
5 Address for Correspondence
6 Cell Phone
7 Landline(With STD Code)
8 Email
9 Permanent Home Address
10 Educational Qualification
Class Year of passing Subject School/College Board/University % of Marks
10th
10+2
BA/BSc/B.Com/B.Tech/BBA/BCA

Note:A Student appearing in final exam/10+2 exam as the case may be, may also apply for registration and intimate the marks obtained by him/her immediately after the final year/10+2 result is declared.
11 Course of ur choice

Note:If the course of your choice are more then one, you should give your preference number for the same.
12

Any other academic/extra curricular/sports achievements
13 I came to know about the Institute from(News Paper/Friends/Relatives/Others etc.)
14

I solemnly declare that the information provided above is accurate and authentic to the best of my Knowledge and my admission may be cancelled in case of any discrepancy found regarding this information. I accept that fees paid at the time of admisstion will not be refunded in any case.

15 Date:
16 Place:




Details of Demand Draft
 
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DD Date:  Bank Name: 
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