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Personal Information

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Mother's Name
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Category
BPL (Tick if Applicable)
Marital Status
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DETAILS OF QUALIFICATION EXAMINATION

Examination Year Of Passing Name of College/School Board Marks
Max. Obtained Percentage
10th Std.
10+2
Graduation
Other

DETAILS OF PARENTS

Particular Mother Father
Occupation & Designation
Annual Income
Office Address
Phone

VERIFICATION CODE
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DECLARATION BY STUDENT

I hereby declare that all the above statements are true and correct the best of my knowledge and belief. I shall obey all the Rules and Regulations of the organization.