CONTACT US: +91 4885- 289991


* Attention!! Candidates are requested to enter all the data in the application form.


APPLICATION FORM

Note: Maximum allowed image size is 500KB


Name of applicant :
Father´s / Husband´s Name :
Sex :
Male Female
Date of Birth & Age :
Religion ( With sub class ) :
Whether you belons to any
Reservation category
( Kindly give details )
:
SC ST OBC SEBC BPL OTHERS NA
Nationality :
Mother Tonge :
Permanent Address :
Address for Communication :
Eligibility for BDS :
+2 B Sc
Board of Examination :

Details of Qualifying Examination
Subject Maximum Marks Marks Obtained
English
Second Language
Physics
Chemistry
Biology
Mathematics
(Please attach the attested copies of statements of marks)
Name & Address of the Institution last studied :
Category in which you seek admission :
NRI Management Government
Whether the candidate seeks hostel facility :
Yes No
Whether the candidate appeared for
Medical Entrance test
:
Yes No
Authority which entrance test conducted :
State National
Details of entrance test :

Application Fee Details
Amount DD Number Date Name of Branch Name of Bank
DECLARATION
I do here-by declare that, I have gone throughthe instructions for admission carefully and I undeertake to abide the rules and regulations of the Institution at present in force or that may hereafter be made for the administration of the college and hostel. So long as I am a student of the college, I will not do anything unworthy to a student. I am aware that tha management is the sole authority to expel me for disinterest in studies, misbehavior and continues failure in exams.
   I accept the Declaration.