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APPLICATION FORM

All * fields are mandatory

*FULL NAME:



(Name as recorded in the Matriculation/Secondary Examination Certificate. Do not use Mr./Ms.)



*DATE OF BIRTH


(DOB should be same as in 10th marksheet)



*EMAIL ID



*RE-ENTER EMAIL ID



ALTERNATE EMAIL ID (Parent)



*MOBILE NUMBER



*RE-ENTER MOBILE NUMBER



ALTERNATE MOBILE NUMBER (Parent)


*GENDER

*MARITAL STATUS