APPLICATION FORM : MMS ADMISSION

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I declare that all information provided by me in this application for admission is correct and complete to the best of my knowledge. Please note the NEFT details below.

NEFT Details
National Kannada Education Society
A/c No:- 76020100005909
Bank Name:- Bank of Baroda
IFSC Code:-. BARB0VJWADA

After payment, kindly REMEMBER to send the NEFT details to ganapati.kattige@svims.com.

Email *

Date of application (DD-MM-YYYY) format. For example: if it is 6 April 2020 then to be written as 06-04-2020 *

PART I - Personal Particulars

Name : *

Gender : *

Female

Male

Other:

Date of birth (DD-MM-YYYY) format. For example: if it is 6 April 1999 then to be written as 06-04-1999 *

Marital Status :

Place of Birth / District *

State : *

Nationality : *

Religion :

Whether belong to Reserve Category : *

Yes

If yes, which category :

OBC

Other:

Clear selection

If others, specify :

Residential Address : *

Permanent Address : *

Mobile No. : *

Phone No. :

Alternate No.:

Alternate Email id :

PAN No. :

Driving Licence No.

Adhaar No. : *

Passport No.

Place of Issue :

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