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University

Course

Full Name

Father's Name

Mother's Name

Full Address

State

City

Pincode

Phone No. with STD Code:

Mobile No.:

E-mail ID:

Date of birth

Gender

Category

Nationality

Religion

Student Status:

Name of Examination	Year of Passing	Name of University/Board	Division/Grade
10th		CBSE BOARD
12th		CBSE BOARD
UG		DBRAU
PG
OTHER

10th Class Doc.

12th Class Doc.

UG Doc.

PG Class Doc.

Other Doc.

Student Signature

Student Photo

DECLARATION

I hereby declare that the information furnished here in above is true and correct to the best of my knowledge and belief. I further declare that the attested photocopies of the certificates submitted by me at the time of admission are true copies of the originals. I have read the prospectus and the rules and regulations of the University. In case any information is found incorrect, at any stage, I agree to forego the fee deposited and also the claim for admission.

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Online Admission