Name of the Applicant: Date of Birth Gender Marital Status Upload photo: Category Permanent Address PIN Telephone Mobile Local Address PIN Telephone Mobile Email Id Adhar Card No. CET / CMAT SCORE Year

Details of Educational Qualifications:

Exam	Month and Year of Passing	Name of the Institute/ Board	Total Marks Obtained and Percentage	Subjects Taken at Examination
S.S.C. OR Equivalent
H.S.C.OR Equivalent
Graduation
Any other Qualification

Details of Work Experience

Name and Address of Employer	Date of Joining	Date of Leaving	No. of Months Years in the Job	Last Salary Drawn

Details of Family Background:

a)Name of Father and Qualification: b)Name of Mother and Qualification: c)Occupation and Designation of Father, Mother/Guardian: d) Complete Address of Work Place of father/ Guardian:

e) Annual Income (Father) Phone Emailid f) Annual Income (Mother) Phone Emailid

DECLARATION TO BE SIGNED BY THE CANDIDATE

I hereby declare that
1. I have read all the rules of admission for the current year and after understanding these rules I have filled in this form of application for the current year.
2. The information given by me in my application is true to the best of my knowledge and belief.
3. I have not been debarred from appearing at any examination held by the Government or any statutory examination authority in India.
4. I hereby agree to conform to any rules, acts and laws enforced by the Government and I hereby undertake that so long as I am a student of the college I will do nothing either inside or outside the college which may result in disciplinary action against me under the rules, acts and laws as prescribed from time to time.
5. I fully understand that the Director with other competent authorities of the management of the college will have the liberty to expel/ rusticate me from the college for any infringement of the rules of conduct and discipline prescribed by the College/ University from time to time.
Place Date Signature