Application Form

Course :- Diploma in Elementary Education

Session :- 2021-23

Please Fill the Admission form in BLOCK/CAPITAL Letters

1) Name of Candidate
2) Father’s Name
3) Mother’s Name
4) Date Of Birth (As Per Certificate)
5) Gender
6) Categories(GEN/EBC/BC/SC/ST/Other)
7) Religion
8) Nationality
9) Divyang
10) Adhar No.
11) Pan No.
12) Mobile No.( WhatsApp No.)
13) E-mail
14) Permanent Address with PIN Code
15). Educational Details.
Name of Exam School/College Name Board/University Passing Year Division Percentage
Matric
Intermediate
Graduation
Post Graduation

I Hereby Declare That All the Information Given by Me Are Correct and I Will Submit All Related Documents & Photo to the College and Give Original Documents for Verification.


Please print your form before submission.