Application Form
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Name of the Student:(As per your certificate) *
Name of Course *
Student Mobile No *
Father's Name *
Parent Mobile No *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Name of District *
Name of the State *
Name of Taluk *
Student First Graduate Yes / No *
10th Total Marks *
12th EXAMINATION REGISTER NO *
12th Total Mark
Year of 12th Examination Passed *
12th Std Group (Subjects) *
Community *
Submit
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