Batch - 2018-20
Email address *
Dear Student,

You are requested to kindly fill the form and submit the same latest by 29th May. The inputs provided by you will help us to know and guide you better on the Orientation Day.

Personal Information
Name *
Contact Number *
Email ID *
Gender
Date of Birth
MM
/
DD
/
YYYY
Blood Group:
Father's Name
Father's Contact Number
Local Address
Permanent Address
Local Guardian Details (If different from above)
Name
Mobile Number
Relationship
Contact in case of emergency
Name *
Mobile Number *
Relationship *
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