Student Application Form
Application
Please fill out the application form carefully
Full Name
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Father Name
*
Father Occupation
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Businessman
Govt job
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Father Mobile Number
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Select Country code
+91
+94
+880
+95
+977
+975
Mother Name
*
Mother Occupation
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Mother Mobile Number
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+91
+94
+880
+95
+977
+975
Annual Income of Parents
Date of Birth
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Gender
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Category
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Nationality
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Address
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Select Country
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Select Country code
+91
+94
+880
+95
+977
+975
Course name
*
B.Pharma
D. Pharma
B,Sc. Nursing
Post Basic B.Sc. Nursing
GNM
ANM
B. Physiotherapy
Baslp
DMLT
BHM&CT
M.TECH (CSE)
M.TECH (MECHANICAL)
M.TECH (CIVIL)
B.Tech (Honors) Computer Science Engineering
B.Tech (Honors) Electronics & Communications Engineering
B.Tech (Honors) Mechanical Engineering
B.Tech (Honors) Electrical Engineering
B.Tech (Honors) Civil Engineering
B.Tech Leet (Honors) Computer Science Engineering
B.Tech Leet (Honors) Electronics & Communications Engineering
B.Tech Leet (Honors) Mechanical Engineering
B.Tech Leet (Honors) Electrical Engineering
B.Tech Leet (Honors) Civil Engineering
Diploma Civil
MBA
BBA
D.VOC
High School
10+2
Entrance exam
Diploma/Graduation
I declare that entries made by me in this application form are true in all respects.