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Matric/10th Details

Matric/10th Pass Type : * Matric/10th Admit Card Number

(if available):

Matric/10th Pass Year: * Date of Birth : *

Maximum Marks : Marks Obtained :

Gender * : Division/Grade Obtained:

Personal Details
Applicant Name * :

Parents are alive or not * Yes No

Father is alive or not*: Yes No

Mother is alive or not*: Yes No

Staying with Guardian * : Yes No

Mother’s Name*:

Mother’s Occupation*:

Father's Name *:

Family Income * : Category*:

Father Occupation*:

Father’s Pan Number:

Father UID;

Last Year Class Details

Last Year Study(Class)*:

Last Year Total Marks*:

Last Year Division/Grade Obtained*: Last Year Marks Obtained*:

College Details
District*: Block*:

University/ Board*:

College * :

Present Mode of Study*:

College Email: College Mobile No:

College Admission No. *: College Admission Date*:

Course *:
Present Studying Course Year *: Scholarship Type * :

District*: Hostel Name*:

Block*:

Hostel Admission Date*:

Student Bank Account Details

Bank District *:

Bank Name *:

Bank Branches *:

Bank Account No.* : *

Communication AddressState *
State*: District*:

Address*:

E-mail : Block:*

Mobile No. : Pincode *:

Permanent Address
District *

Block*: Address *:

Pincode *:

Aadhaar Details
Aadhaar No.(UID)

Upload Documents

Student Photo*

Residential Certifocate Issuance namber of Residential Certifocate

Issuance date of Residential Certifocate

Cast Certifocate Issuance namber of Cast Certifocate

Issuance date of Cast Certifocate

Income Certifocate Issuance namber of Income Certifocate

Issuance date of Income Certifocate

1.College Bonafide Certifocate 2.Student Previous Year Marks Sheet 3.Student Bank Account Passbook