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Course
Name*
Father's Name*
Date Of Birth*
Categery		GEN SC ST OBC
Gender		Male Female
Permanent Address
Mailing Address*
Mob.No*
Phone No.(with std code)
E mail ID*

Education Qualification
Exam Passed	Board/council/University	Year Of Passing	% Of Marks/Grade
Matriculation/10^th
Intermediate(10+2)
Graduation
PG
Others

DD I Details:
Course Fee (Rs.)*
DD No		DD Date
Bank Name		DD Amount

DD II Details: (If Any)
DD No		DD Date
Bank Name		DD Amount


Declaration :
The particulars furnished above are true to the best of my knowledge. I promise hereby to abide by the rules and regulations of the institute.; and as amended from time to time. I further undertake that I Shall not ask for any refund/transfer of fees once paid under any circumstances.

I Agree