First Name * Please Enter the Name ! only characters allowed
Last Name * Please Enter the Last Name ! only characters allowed
Gender * --Select-- Male Female Others Please Select Gender !
Martial Status * --Select-- Single Married Please Select Martial Status !
College / University Registration No * Please Enter College / University Registration No !
Unique Id Type * --Select-- Voter ID PAN Card Passport Aadhaar Marks Card Please Select Unique Id Type !
Unique Id Number * Please Enter Unique Id Number !
Community * --Select-- OC BC MBC SC ST Others Please Select Community !
Other Community *
Physically Challenged * --Select-- Yes No Please Select Physically Challenged !
Religion * Please Enter Religion ! only characters allowed
Family Annual Income * --Select-- Below 2 Lakh Per Annum Between 2 Lakh – 5 Lakh Per Annum Between 5 Lakh - 7 Lakh Per Annum Above 7 Lakh Per Annum Please Select Family Income !
Year of Passout * --Select-- 2023 Please Select Year of Passout
Parent/Guardian First Name * Please Enter the Parent/Guardian First Name ! only characters allowed
Parent/Guardian Last Name * Please Enter theParent/Guardian Last Name ! only characters allowed
Relationship with Guardian * --Select-- Father Mother Brother Sister Others Please Select Relationship with Guardian
Parent/Guardian Contact Details * Please Enter the Parent/Guardian Contact Details ! Contact number should in numeric digits!
Who is Highest Educated in Family * --Select-- Father Mother Brother Sister Self Please Select Highest educated in family
No. of Family Members * Enter the No. of Family Members Please Enter Only Numbers
Highest Educated Qualification in Family * --Select-- 10th 12th Graduate Post Graduate PhD Please Select Highest Educated Qualification in Family
Profession of Chief-wage Owner * Please Enter the Profession of Chief-wage Ownere ! only characters allowed
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