Your Name (required)(Write your name as you want it to be printed on the Certificate)
Your Email (required)
Address
Sex (required) MaleFemale
Telephone No. (required)
Date of Birth (required)
Father’s Name (required)
Mother’s Name (required)
Parent Email (required)
Parent Telephone No. (required)
Occupation (required)
Educational Qualification: (required)
Please mention 10th, 12th Diploma, 1st, 2nd, 3rd and Bachelor & Master with Year of passing, % of marks, Name of College and University/Board
Category of applicant(required) OpenSCSTDTNTOBC
I hereby declare that the information given above is true to the best of my knowledge. I have read the selection procedure set forth in the prospectus and related official announcements. I declare that I accept the terms and conditions set forth herein. I recognize the financial obligations & payment dates as stated.

Attach Passport Size Photograph (required)(Less than 1MB)