Basic Information:

Course *

DIPLOMA IT & MANAGEMENT ITI

Branch *

Select Branch Mechanical Engineering Civil Engineering Electrical Engineering Mining Engineering BBA BCA Electrican Fitter Computer Science & Engg

Lateral Entry *

Yes No

Semester *

Select Semester

Session *

2023-25

First Name *

Last Name *

Mother's Name *

Father's/Guardian's Name *

Gender *

Select... Male Female

Blood Group *

Select... A+ A- B+ B- AB+ AB- O+ O-

Aadhar No *

Date Of Birth*

Religion*

Select Religion Hinduism Buddhism Christianity Islam Jainism Sikhism Spiritism Other

Social Status/Community *

Select Community General BC I BC II SC ST

Marital Status *

Select Status Single Married Widowed Separated Divorced

Mother Tongue *

Parents/Guardian Occupation *

Mobile No. *

Parents Mobile No. *

Parents Income *

Postal Address:

Address *

PS*

POST*

Distt.*

STATE *

PIN CODE*

Email *

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Parmanent Address is the Same as Postal Address

Parmanent Address:

Address *

PS*

POST *

Distt.*

STATE *

PIN CODE*

Email*

Qualifying Examination Details:

Exam Passed	Month & Year of Passing	Name & Address of the School/College/University	Marks Obtained(In %)	Div

Profile Picture:

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