12/14/23, 2:01 PM Entrance Registration Application (ERA)

Common Entrance Examination Application Form

Applicant's General Information
(All the * fields are mandatory)

Contact Number:*

9867900132

Email:*

drranosingh1991@gmail.com

Email Address

Applicant's Name:*

RANO

MIDDLE NAME

SINGH

Gender :*

Female

Date of Birth :*

YYYY/MM/DD MM/DD/YYYY

BS (YYYY/MM/DD) AD (MM/DD/YYYY)

Identification Type :*

Passport

Passport No: *

Issued By:

Issued Date:

YYYY/MM/DD MM/DD/YYYY
BS (YYYY/MM/DD) AD (MM/DD/YYYY)

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Permanent Address Detail (As per Citizenship)

Country:*

India

Full Address: *

External Entrance Score

Country:*

India

Guardian Info

Father:*

NAME

Contact No

Email

Profession

Qualification

Address

Organization

Organization's Address

Mother:*

NAME

Contact No

Email

Profession

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Qualification

Address

Organization

Organization's Address

Guardian:*

NAME

Contact No

Email

Profession

Qualification

Address

Organization

Organization's Address

Relation

School Type(Grade 6 to SEE)*

Select School Type

Only those candidate who studied in community school from grade 6 to 10 (SEE) should select
Government and upload approved document.

Document Uploads

Photo : * (JPEG or PNG format)

Select Document to upload

Recent passport size photo

Passport * (FRONT Side) (JPEG or PNG format)

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Select Document to upload

Passport * (BACK Side) (JPEG or PNG format)

Select Document to upload

Signature Scan:* (JPEG or PNG format)

Select Document to upload

I hereby declare that the information given above and the documents uploaded are true and
correct. If something is found false and/or incomplete, I shall be fully resposible and I accept any
decision of MEC to disqualify my admission application.


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