NameFather's Name /Gurdian's Name required. *Email AddressVILLAGE/CITY *POSTPSDistrictPostal CodeMOBILEDate of BirthGender *GENDER -MaleGENDER-FemaleGENDER-OtherCategory *GNSCSTOBC-AOBC-BMinorityPHCOURSE APPLIED FOR *Please select an optionCITADITACFASDFASCDTPDDTPCCADDCADCCHMDCHMSessionJAN-JUNEJULY-DECAPRL- SEPTOCT- MAREXAM PASSED *YEAR *BOARD/UNIVERSITY *%OF MARKS/GRADE *EXAM PASSEDYEARBOARD/UNIVERSITY%OF MARKS/GRADEEXAM PASSEDYEARBOARD/UNIVERSITY%OF MARKS/GRADEDate of AdmissionUpload fileChoose FileNo file chosenDelete uploaded fileConsent *Declaration: We do here by declare that the above particulars given herein are correct & true to our knowledge and the Centre authority shall have the piower to cancel the candidature on detection of any wrong and same for any breach of rules and regulations / discipline & loss or damage of Centre property made by him at any period of study here and we shall accept same without any protestSUBMIT YOUR FORM