Application Form

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Name of the Applicant:
Date of Birth:
Gender:	MaleFemale
Category:	GENSCSTMinorityOthers
Programme Applied For:
Mobile No:
Whatsapp No:
Passport No:
Landline No:
Aadhaar No:
Blood Group:
Student's Email:
Residential Address:
City-Town:
Pin Code:
Permanent Address:
City-Town:
Pin Code:
Nationality:
Family Profile
Father’s Name:
Contact No:
Mother’s Name:
Contact No:
Annual Family Income:	Below 4.5 Lakhs4.5 - 10 Lakhs10 Lakhs And Above
Entrance Exam Appeared:	PGCETK-MATXATMATCATATMAICETOther Exams
Academic Qualification Exam Passed in 10th:
School / College:
Board / University
Year Of Passing:
Mention Your Score(%):
Academic Qualification Exam Passed in PUC/12th:
School / College:
Board / University
Year Of Passing:
Mention Your Score(%):
Academic Qualification Exam Passed in Degree:
School / College:
Board / University
Year Of Passing:
Mention Your Score(%):
Hostel Facility:	YesNo
Input this code:

Name of the Applicant:
Date of Birth:
Gender:	MaleFemale
Category:	GENSCSTMinorityOthers
Programme Applied For:
Mobile No:
Whatsapp No:
Passport No:
Landline No:
Aadhaar No:
Blood Group:
Student's Email:
Residential Address:
City-Town:
Pin Code:
Permanent Address:
City-Town:
Pin Code:
Nationality:
Family Profile
Father’s Name:
Contact No:
Mother’s Name:
Contact No:
Annual Family Income:	Below 4.5 Lakhs4.5 - 10 Lakhs10 Lakhs And Above
Entrance Exam Appeared:	PGCETK-MATXATMATCATATMAICETOther Exams
Academic Qualification Exam Passed in 10th:
School / College:
Board / University
Year Of Passing:
Mention Your Score(%):
Academic Qualification Exam Passed in PUC/12th:
School / College:
Board / University
Year Of Passing:
Mention Your Score(%):
Academic Qualification Exam Passed in Degree:
School / College:
Board / University
Year Of Passing:
Mention Your Score(%):
Hostel Facility:	YesNo
Input this code: