Dear friends! Please fill up all the columns CORRECTLY.

Incase of not knowing your hsc discipline date please fill up with the year of starting and finishing. Send it within 2 days of receiving this mail. PERSONAL DETAILS
ROLL NO NAME GENDER DATE OF BIRTH AGE(X YEARS ,Y MONTHS) FATHERS NAME FATHERS OCCUPATION MOTHERS NAME MOTHERS OCCUPATION PHONE NO(MOBILE) PHONE NO(LANDLINE) E-MAIL ID PERMANENT ADDRESS HSC DISCIPLINE WITH START DATE AND END DATE 12 MARK(PERCENTAGE) 10TH DISCIPLINE WITH BATCH 10TH MARK(PERCENTAGE) : : : : : : : : : : : : : : : : :

DIPLOMA DISCIPLINE WITH START DATE AND END DATE :

DIPLOMA MARK(PERCENTAGE) :

UG SPECIALIZATION SEMESTER 1 SEMESTER 2 SEMESTER 3 SEMESTER 4 SEMESTER 5 SEMESTER 6 UG CGPA OR PERCENTAGE NO OF CURRENT ARREARS NO OF HISTORY OF ARREARS IDENTIFICATION MARKS

: : : : : : : : : : :

JOB EXPERIENCE(COMPANY NAME) : ANY GAP IN STUDIES?(Y/N)(IF YES STATE THE REASON) BLOOD GROUP : :

THANKS FOR YOUR CO-OPERATION