Hostel Admission Form

Candidate Name *

Email *

Mobile Number *

Date of Birth *

Place *

Nationality *

Category * ex- Gen/OBC/ST/SC/PH/Minority(Mulism/Sikh/Buddhist/Christian/Parsee)

Religion *

Mother Tongue *

Admission in Course *

Under Graduate Post Graduate Skill Development Courses

Courses *

Current Address

Current Mailing Address *

State *

Postal Code *

Phone Number *

Permanent Address

Permanent Address *

State *

Postal Code *

Phone Number *

Family Details

Father's Name *

Profession / Business

PAN No. *

Position Held / Nature of Business *

Total Annual Income

Contact Phone Number *

Mobile Number *

Office Address *

Mother's Name *

Profession / Business

PAN No. *

Position Held / Nature of Business *

Total Annual Income

Contact Phone Number *

Mobile Number *

Office Address *

Medical Details

Fill the Hostel Admission Form