PERSONAL DETAILS

Name ………………………………………………………………………………………………..
Father’s Name. ………………………………………………………………………………………
Mother’s Name ……………………………………………………………………………………...
Date of Birth. ……………………………………………………………………………………......
Aadhar No ……………………………………………………………………………………...........
Category ……………………………………………………………..……………………………...
Body Mark ….………………………………………………………..……………………………...
Body Mark ….………………………………………………………..……………………………...
Mobile No …………………………………………………………………………………………...
Email Id. ……………………………………………………..……………………………………...
Email Password ……………………………………………………………………………………..
Address ……………………………………………………………………………………...............
……………………………………………………………………………………………………….

ACADEMIC CREDENTIALS

Degree Subject University (City) Year Percentage Roll No.

10th

12th

UG

PG

BANK DETAILS

AC HOLDER
BANK NAME AC NO IFSC CODE
NAME

CERTIFICAT
NO DATE INCOME
E

INCOME

CAST