Application of Student Membership
* Name : * Gender :
* Father Name : * Mother Name :
* Date of Birth :    * State of Domicile :
* Permanent Address : * Corres. Address :

* State * State
* Contact No.   Email ID
   Father Contact No.   Mother Contact No.
   Father Occupation   Mother Occupation
   Family Annual Income   Aadhar Card No.
* Nationality   Blood Group
  Upload Photo
(Max Size 2MB)
 * Category :
* Religion   Upload Signature
(Max Size 2MB)
 
Educational Qualifications
Name of Exam Year Board/University Percentage Marksheet No. Subjects
              
                   
                   
                   
                   
* Session :   * Mode :
* Quota : * Course :

Scheme :  Choose Institute : 


Referral Information
Preferred Seat Type
* Referral * Seat Type
(For Free Seat You Should
Have Scored
70% or above in class 10th)
* Name :
* Contact No. :