Name of the Applicant* :
* As per Matriculation Certificate(Do
not use Salutation before Name Like: Mr/Ms/Mrs. etc.)
Father's / Guardian's Name* :
* As per Matriculation Certificate(Do
not use Salutation before Name Like: Mr/Ms/Mrs. etc.)
Date of Birth* :
* As per Matriculation Certificate
Physically Disabled :
Note: If yes, then submit attested Medical
Board Certificate
Password* :
* Eg: abc@1234
Note: (Minimum eight characters, at least one letter, one number and one special
character.)