Name of the Applicant

Course Select Course NEET-UG IIT-JEE CLAT-LAW FOUNDATION

Gender Select Gender Male Female Transgender

DOB

Father Name

Mother Name

Annual Income of Father/Mother/Guardian

Adhaar

Permanent Address

Student Mob.

E-mail-ID

Guardian Mob.

Applicant Bank Account Details:

Name of Bank

Branch

A/c No

IFSC Code

Candidate Belonging to Community Select religion Hindu Muslim Sikh Jain Budhist Parsi Christian Any other Jew

Candidate Category Select Category/Caste General SC ST OBC

Declaration:- Agree to attend the course as per rules understand the association with any unlawful organization is forbidden if selected for admission agree to abide by the rule and discipline of the institute all particular stated above are true to the best of my knowledge & belief.