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Name of the candidate (in capital letters) :   
Name in mothertongue :   
Date Of Birth :   
Gender :     Male     Female     Transgender
Religion :     Christian     Hindu     Muslim     Others
a. If Christian, then denomination :   
Name of father/guardian :   
Mobile number of father/guardian :   
Name of mother :   
Mobile number of mother :   
Occupation of father/guardian :   
Occupation of mother :   
Name of the institution in which the candidate last attended :   
Number of chances taken to pass the qualifying examination :   
Details of examinations :   
Course Borad Year of study Grade Percentage
Permanent Address with District :   

Pin:   Phone number:
Address for communication (if different from permanant address) :   

Pin:   Phone number:
Comments :   
  I do hereby declare that the above stated particulars are correct and true to the best of my knowledge and belief. I will abide by the rules and regulations of the college.