First Name * Please Enter the first Name ! only characters allowed
Last Name * Please Enter the Last Name ! only characters allowed
Father's Name * Please Enter the Father Name ! only characters allowed
Mother's Name * Please Enter the Mother Name ! only characters allowed
Gender * --Select-- Female Please Select Gender !
Martial Status * --Select-- Single Married Please Select Martial Status !
Aadhar Number * Please Enter Aadhar Number ! Aadhar number should in numeric digits!
Community * --Select-- General OC BC MBC SC ST Others Please Select Community !
Other Community *
Religion * Please Enter Religion ! only characters allowed
Physically Challenged * --Select-- Yes No Please Select Physically Challenged !
Family Annual Income * --Select-- Below 1 Lakh Per Annum Between 1 Lakh - 2 Lakh Per Annum Between 2 Lakh - 3 Lakh Per Annum Less than 3.5 Lakh Per Annum Above 3.5 Lakh Per Annum Please Select Family Income !
Age * Please enter the Age ! Please Enter Only Numbers
University Registration Number * Please enter the university registration number !
Father Occupation * Please enter the Father Occupation !
Mother Occupation * Please enter the mother Occupation !
Is the Student first Generation learner * Select Anyone Yes No Please Select Select Anyone !
Is the Student a single parent child * Select Anyone Yes No Please Select Select Anyone !
Which year of graduation is the student pursuing * Select Anyone 4th Year 7th Semester 4th Year 8th Semester 3rd Year 5th Semester 3rd Year 6th Semester 2nd year 3rd Semester 2nd year 4th semester 1st Year 1st Semester 1st Year 2nd Semester Please Select Select Anyone !
Year of Passout * Select Anyone 2024 Select Anyone
Email-id * Please Enter the Email Address ! Enter a valid email id!
Mobile Number * Please Enter the Mobile Number ! Contact number should in numeric digits!
Door No / Flat / Street * Please Enter Door No / Flat / Street
Area / Location * Please Enter Area / Location
State *
District *
City * Please Enter the city !
Pin Code * Please Enter the area pincode ! Please Enter Only Numbers