Application
Name of Applicant
Father Name
Mother Name
Gender
Select Gender
MALE
FEMALE
TRANSGENDER
Date of Birth
Select Category
Select Category
Category-1
GM
IIA
IIB
IIIA
IIIB
OBC
SC
ST
Religion
Nationality
Select Nationality
Indian
Others
E-mail
Mobile Number
Landline Number (With STD Code)
Permanent Address
Address Line - 1
Address Line - 2
Address Line - 3
District
Pincode
State
Communication Address
Address Line - 1
Address Line - 2
Address Line - 3
District
Pincode
State
Candidate Occupation
Candidate Annual Income
Parents Occupation
Parents Annual Income
Whether Belongs to Minorities
Whether Belongs to Minorities
No
Yes
Belongs to Economically Weaker Section
Whether Belongs to Economically Weaker Section
No
Yes
Handicap
Select Handicap
None
PHC
VHC
Graduation/Diploma
Course
Optional Subject
Subject
Medium
Select
Kannada
English
Urdu
Total Amount
Subjects
Sl.No.
Subject Name
Attached Photo
00000001800000000181000000027700000003750000000376000000037700000003780000000379000000038000000003810000000382000000038300000003840000000385000000038600000003870000000388000000038900000003900000000391000000039200000003930000000394000000039500000003960000000397000000039800000003990000000400000000040100000004020000000403000000040400000004050000000406000000040700000004080000000409000000041000000004110000000412000000041300000004140000000415000000041600000004170000000418000000041900000004200000000421000000042200000004230000000424000000042500000004260000000427000000042800000004290000000430000000043100000004320000000433This Application Already Submitted Please Contact Admin For Any Changes
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