Student Name

Date

Session

Date Of Birth

Gender

Father's Name

Father's Mobile

Mother's Name

Religion

Caste

Category

Address

City

State

Pin

Email Id

First Preference :

College Name

Course Name

Branch Name

Other Preference :

College Name

Course Name

Branch Name

Roll No. Of Last Exam

10th(%)

Result is Awaited

12th/Diploma/Graduation(%)

Result is Awaited

School / College Name

PCM/PCB(%) (For UG)

Appeared In Any Entrance Exam
Yes No

College Transfer

Is Lateral Entry

Application For :

Hostel Bus

Remarks

Counselor Reference

Student Mobile

OTP