Form No : 86099
Candidate Name  
As per 10th class certificate [ Capital Letters ]




(Image Size should be less than 1 MB )
Fathers Name :  
As per 10th class certificate [ Capital Letters ]
Street | Village  
District  
State | Country
Date of Birth :  
( DD / MM / YYYY)
Gender : Religion :  
Category : Mobile   :  
Semester : Email     :  
Course Applied :

SELECT ANY 1 OF THE FOLLOWING SUBJECT COMBINATION FOR 1ST SEMESTER

SELECT ANY 1 OF THE FOLLOWING SUBJECT COMBINATION FOR 2ND SEMESTER

Class Exam Roll No. Board/University RegNo. Session/Year
 of Passing
Annual / BiAnnual Maximum Marks Marks
Obtained
Board / University
12th          
Grad          
Dated : 3/20/2019
.

• Attested Copy of Gradudation marks certificate.