Admission Form

PERSONAL DETAILS

Name*
DOB*
Gender*
Blood Group*
Father's Name*
Mother's Name*
Guardian Name*
Mobile No*
Aadhar No*
Occupation*
Annual Income
Nationality*
Religion*
Caste*
Photo *Size below 200 KB
Guardian Signature Size below 200 KB
Candidate Signature *Size below 200 KB

PERMANENT ADDRESS

Country*
State*
District*
City*
Address*
Pin Code*

COMMUNICATION ADDRESS
Same as Permanent Address

Country*
State*
District*
City*
Address*
Pin Code*

EXAMINATION PASSED

Serial NAME OF THE Examination Board/University Name Passing Year Full Marks Obtained Marks % OF MARKS OBTAINED
1 MADHYAMIK / EQUIVALENT EXAM
2 HIGHER SECONDARY / EQUIVALENT EXAM
3 B.A. / B.SC. / B.COM. (HONOURS)
4 M.A. / M.SC. /M.COM / M.E. / M.TECH.
CONTACT INFO
  A/92, N.S.B. Road, Near Royal Care Hospital, Panjabi More, Raniganj, Dist:- Paschim Burdwan, State: West Bengal Pin code - 713347
                   
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