Application Form
Note  : 1. (*) Denotes mandatory fields. (Form will not be processed if ALL mandatory fields are not completed)
            2. Date should be entered in DD-MM-YYYY format

PLEASE DON'T USE Mr./Ms./Sh./Smt. etc. in Candidate Name/Father Name & Mother Name
Name of the Candidate * :
Father's Name * :
Mother's Name * :
Category * :  
Sub-Category * :  
Contact No. * (10 Digits only) :  
Email ID :
 
 
Date of Birth * :
 
Sex * :  
       
Minimum (%) of Marks in 10+2 or its equivalent Examination/Appearing * :
Nationality  * :  
       
Candidate's Complete Mailing Address    
Correspondence Address * :  
     
Pincode * :  
Same As Above 
Permanent  Address * :  
     
Pincode * :  
District to which belongs * :  
Revenue Sub-Division to which belongs * :  
Bonafide District * :  
       
Preference Regarding Examination Centre District and Sub-Division
District (For Exam. Centre) * :
Revenue Sub-Division (For Exam. Centre) * :