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Jhykycgknqj'Kkl HJKF"V Lalñrfo - Kihbe ) Uonsgyh: Application Form
Jhykycgknqj'Kkl HJKF"V Lalñrfo - Kihbe ) Uonsgyh: Application Form
APPLICATION FORM
Please read the guidelines carefully before filling up the Application Form
Please use Blue Ball point pen in the boxes using English CAPITAL LETTERS or English Numerals.
Write in CAPITAL LETTERS only within box. Leave blank between words as shown in the example below:
1. Application For:
Please Enter Course Name
16. Category – II
i.) Children/War Widow of Armed Personnel (Yes/No): Yes/No
If it is YES, Please Tick mark ()
a. Battle Casualty
b. Physical Casualty
vi.) Sports person (Yes/No): Yes/ No vii.) NCC /NSS Cadet: Yes/ No
If it is YES, Please Tick mark () If it is YES, Please Tick mark ()
a. National a. NCC –‘B’ Certificate b. NCC –‘C’ Certificate
b. International c. NSS –Certificate
17. Correspondence Address: (Give space between words)
a) House No: b) Street
c) Locality/
Mohalla
d) Tehsil/
District
e) City f) State
g.) Pincode
c) Locality/
Mohalla
d) Tehsil /
District
e) City f) State
g.) Pincode
b.) E-mail
20. Educational Qualifications:
% age
Qualification Board/University/College Passing Year Marks Obtained Total Marks
(with Decimal)
10th /
Matriculation or
equivalent
12th/
Intermediate or
equivalent
Graduation or
equivalent
Post-Graduation
or equivalent
a) Demand Draft No :
b) DD-Date : D D / M M / Y Y Y Y
c) Bank Details :
Place: .........................................
Date...........................................
(SIGNATURE OF THE APPLICANT)