University/CollegeApplied For      
1. Full Name



2. Sex  Date of Birth

 Nationality

3. Father's Name  Occupation

4. Mother's Name  Occupation


5.Present Address         Zip/Pincode
Country Code  Areacode  TelPhone

 
6. Permanent Address  Zip/pin code

Country Code  Area code  TelPhone

 
7. Email




 
8. Educational Qualification

 a) Certificate/   Diploma/Degree Obtained 



b) Name of School/College/
University Last Attended

c)Percentage of Marks  d) Year of Completion

 If the student / applicant hold no passport please mention                                       
9. a) Applicants Passport No  b) Place of  Issue  c) Date of Issue

e) Date of Expiry 

                                 











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