Registration Form

STUDENT REGISTRATION FORM

Course Applied for
Academic Session
Personal Details :

Name (In BLOCK LETTERS) :

Fathe's Name :
Mother's Name :
Date of Birth :
Gender
Place of Birth :
Nationality :
Domicile of Haryana :
Category :
Permanent Address:
Pin :
State:
Telephone No. with Code
Mobile No. :
Email :
Address for Correspondence:
Pin :
State
Telephone No. with STD Code
Mobile No.
E-mail
Qualifications
SI NO. Examination Degree Major Subject/Discipline Year Of Passing Institute/University Name Marks Obtain/Percentage
1 10th
2 10+2 Equivalent
3 Bachelors
4 Masters
5 Any Other
Details of Academic Performance
SI NO. Nature of Responsibility Duration Number of year/month
1
2
3
4
5
Qualifications
SI NO. Particular Mother Father Guardian
1 Name
2 Occupation & Designation
3 Annual Income
How did you come to know about
Accommodation :
Date:
Undertaking By the Applicant

I certify that I have read the Amission Notice and that all the information I have provided in this application is true and correct

Attachment

Applicant's Signature Pic