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Student Name *

Student Aadhar Number *

Gender * Select Gender Male Female Others

Father Name *

Mother Name

Qualifying Exam Passed * Select 10th 12th ITI

Select Community Select Community OC BC MBC/DNC SC ST Other

Date of Birth

Mobile Number *

Alternative Contact Number

Email ID *

Select Year of Admission * Select 1st Year Admission Direct IInd year Admission

Select Courses * Select Diploma In Automobile Engineering Diploma In Civil Engineering Diploma In Mechanical Engineering Diploma In Electrical& Electronics Engineering Diploma In Electronics & Communication Engineering Diploma In Computer Science Engineering Direct IInd year Diploma In Automobile Engineering Direct IInd year Diploma In Civil Engineering Direct IInd year Diploma In Mechanical Engineering Direct IInd year Diploma In Electrical& Electronics Engineering Direct IInd year Diploma In Computer Science Engineering Direct IInd year Diploma In Electronics & Communication Engineering

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Address for Communication *

Need Transport Facility* Select Yes No