Application for Reservation

APPLICATION FOR RESERVATION

Name of the Candidate*

Father's & Mother's Name*

Date of Birth (DOB) & Age*

Gender*

Male

Female

Community*

MBC/DNC

Father's Occupation

10th (or) 12th Reg No*

12th Board of Studies*

Subjects / Groups Studied in 12th*

Previous School / College*

Preferred Course (with Branch)*

Preferred College (with Campus)*

Address for Communication*

Pincode

Mobile Num*

WhatsApp Num

E-mail ID*

Student Aadhaar Number*

Local Guardian's Address

If Certificates of Original Submitted (Enclosed)

Reference*

*Required fields
Note: The Advance Payment is not refunded for any reasons and in case of failure of Examinations only refundable with supporting document.

Date

Place

Signature of the Parents or Guardians

Signature of the Candidate with Date

APPLICATION FOR RESERVATION

🎓 Your Application Has Been Successfully Submitted