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APPLICANT INFORMATION

FIRST NAME: MIDDLE NAME: LAST NAME:


DATE OF BIRTH: PLACE OF BIRTH:

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PARENT INFORMATION

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RELATION WITH APPLICANT :
OCCUPATION OF PARENT :
EMAIL ID :
MOBILE NO :


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ACADEMIC INFORMATION OF APPLICANT
    

  10th Standard 12th standard Graduation
NAME OF INSTITUTION:
BOARD/UNIVERSITY:
QUALIFIED YEAR:

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I S/O,D/O.DO HEREBY DECLARE THAT THE INFORMATION ABOVE PROVIDED BY ME ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I DO FURTHER UNDERTAKE THAT IN CASE ANY INFORMATION IS FOUND INCORRECT AT ANY STAGE , MY APPLICATION WILL BE CANCELLED,I ALSO AGREE TO ABIDE BY THE RULES OF INSTITUTION, IN CASE OF BREACH OF DISCIPLINE, DISOBEDIENCE OF RULES I SHALL BE LIABLE FOR EXPELATION FROM THE INSTITUTE. THE ORGANIZATION HAS RIGHT TO USE THE INFORMATION FOR COMMUNICATION PURPOSE.