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APPLICATION FORM

Course Applied for:

Name as per printed on Marks sheet:(required)

Name in Hindi / Marathi:(required)

Father’s/Husband’s Name:(required)

Grand Father’s Name:(required)

Mother’s Name:(required)

Martial Status:

Mother Tongue:

Place of Birth:

Gender:

Blood Group:

Religion:

Height:

Weight:

Date of Birth:

Nationality:

Domicile State:

Is Student NRI / Foreign National:

Caste:

Caste Certificate available or not:

Aadhar No.:

Contact No.:1

Email ID:

Contact No.:2

Correspondence Address:

Wing:

Flat / House No.:

Building Name :

Locality:

City/Town:

Tehsil:

District:

State:

Location Area:

Land Mark:

Permanent Address:

Wing:

Flat / House No.:

Building Name :

Locality:

City/Town:

Tehsil:

District:

State:

Location Area:

Land Mark:

Academic Details:

Qualification 1

Qualification:

Institution Name:

Board / University:

Percentage:

Qualification 2

Qualification:

Institution Name:

Board / University:

Percentage:

Qualification 3

Qualification:

Institution Name:

Board / University:

Percentage:

Qualification 4

Qualification:

Institution Name:

Board / University:

Percentage:

Guardian Information:

Guardian Information 1

Name:

Relationship:

Occupation:

Annual Income:

Guardian Information 2

Name:

Relationship:

Occupation:

Annual Income:

Guardian Information 3

Name:

Relationship:

Occupation:

Annual Income:

Extra Curricular Activity:

Name:

Place:

Upload Marksheet:

Upload Photo:

Upload Guardian Signature:

Upload Student Signature:

Counselor Name:

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