Session * 2020-21 2021-22 2022-23 2023-24 2024-25 2025-26

Semester * Semester - 1 Semester - 2 Semester - 3 Semester - 4

Registration/ Roll No *

Student Name *

Father's Name *

Mother's Name *

Date Of Birth *

Category * GEN OBC SC ST Other *

Gender * Male Female Other

Qualification

Roll No

Certificate No

Year

Board

College / School

M.M.

Obt. Marks

High School *

Intermediate /other *

Graduation/ Other *

Address *

Pincode *

Aadhar No. *

Mobile No *

Ulternate No *

Email Address *

Caste Certificate No *

Domicile Certificate No *

Income Certificate No *

Do you have Oath Certificate? * Yes No

Do you have health Certificate? * Yes No

Upload Photo 50kb only *

Upload Sign 30kb only *

Declaration

I certify that all the above mentioned entries completed by me are true and correct. If there is anything wrong in the above mentioned information, if it is found to be untrue or misleading, then it will be my sole responsibility and the college will be free to take action against me as per rules.

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