Name of the Student:*

Date of Birth:*

Place of Birth:*

State:*

Category:*

General SC ST VJ NT OBC PH

Cast:*

Occupation of Father/Mother:*

Annual Income(Rs.):*

Postal Address:*

Pincode:*

Phone No.(With STD Code Format(xxxx-xxxxxxx)):

Mobile No.:*

Whatsapp:*

Participated in:*

Sports NCC SCOUT RSP NONE

Marks Obtained in Last Exam(%):*