Note** : If the students submitted any false/wrong information the concern individual will be held responsible. Action will be initiated against him/her.

 Applicant Details
E-pass ID No,If Available
SSC Pass Type: *: SSC Exam No: *:
SSC Pass Year: *: Gender: *:
Name of the Student: *:
Name of the Student's Father: *: Name of the Student's Mother: *:
Student Date of Birth(DD-MM-YYYY): *: Previous Studied Course* :
(As per PostMatric Scholarship)
Student Place of Birth * : Student Native Place * :
Father Place of Birth * : Father Native Place * :
Ration Card No. (if available): UID (Aadhar) Number *
Student Disabled*: Yes    No  
Father have Aadhar No *:  Yes     No 
Mother have Aadhar No *:  Yes     No 
Caste *: Sub Caste *:
Profession of Parents/Spouce * : Family Annual Income (Rs) * :
  Details of places & Address of school study from 4th to 10th as per certificates.
Class Name of the School District of School District of Mandal Year of pass
IV *:
V *:
VI *:
VII *:
VIII *:
IX *:
X*:
  Academic Details
  Name of Board/University Stream/Course Year of Passing Marks Obtained Total Marks % of Marks otained Grade /Division
SSC*:
Intermediate*:
Graduation*:
PG

  Bank A/C Details
Bank Name : *
Bank District * :
Bank Branches : *
Bank Account No. :*
Note: Please Provide Valid SB(Savings Bank) account.
As Scholarship Account/Jan Dhan Yojana Account will not accept such big amounts.
  Passport and Qualifying Test Details
Passport No: *: Date of issue: *: (DD-MM-YYYY)
Place of issue *: Date of Expiry: *: (DD-MM-YYYY)
  GRE (or) GMAT Scores
Test Type:
Total Score:
Date of Test
(DD-MM-YYYY):		 Verbal: Quantitative: Analytical:

English Proficiency Test*
TOEFL: IELTS:
 Visa Details :
VISA No.:
VISA Issued by:
Date of Issue : (DD-MM-YYYY)
Date of Expiry: (DD-MM-YYYY)
 Details of Foreign Intitution in Which admission is obtained:
Whether going as Research Scholar * : Yes No
Name of Foreign University and Address * :
Foreign University State Name/Area Address* :
Country of Overseas Study *:
Name of Course *:
Date of Commencement of Course *: (DD-MM-YYYY)
Duration of Course *: (No. of Months)
Are You Applying for Humanities/Economics/Accounts/Law/Arts *: Yes   No
Admission letter No./I20 No.Or Equivalent Document *:
If you Have I20 Mention Institution Code : Approval Date:
Total Tution Fee(in INR) * : Currency Converter
Total Living expenses(in INR) *:
Total(in INR) * :
Candidate Address for Communication *:
District where student has studied Graduation/PG *:
If any Scholarship/Stipend being sanctioned by abroad University /College if any * : Yes No
 Communication Details:
District * Mandal *
Village * Door No. *
Pincode * Applicant Mobile No. *
Father/Gardian Mobile No. * Mother/Gardian Mobile No. *
Email ID *
1.Classmates/Relatives Mobile No. 1.Classmates/Relatives Email ID.
2.Classmates/Relatives Mobile No. 2.Classmates/Relatives Email ID.
 Income Certificate Details: (Income/EBC certificate)
Mee Seva No. : *
Applicant Name : *
Father Name : *
District : *
Mandal : *
MRO Name : *
Total Income : *
  Caste Certificate Details: (Not Required for OC MINORITY and EBC Students)
Mee Seva No. : *

Applicant Name :*
Father Name : *
District : *
Mandal : *
MRO Name : *
Caste : *
 Documents to be Scanned and Uploaded:
File size should be in between 50kb and 150kb ,  Format:*.jpg/jpeg.
Passport Photograph of Student * :
Bonafide Certificate form institute where candidate has studied last * :
Ration Card :
SSC Certificate * :
Aadhaar * :
Transfer Certificate * :
GRE/GMAT Score Card * :
TOEFL/IETS/PTE/Others Score Card * :
Bank Passbook * (1st page) :
Admission letter from Foreign University (e.q I-20) * :
Passport Copy * :
Residence/Nativity Certificate * :
Mark Sheet of Last Qualified Course (Graduation/PG) Level * :
Mox30D
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  The above details provided are correct and if any information is incorrect , i am liable for further action as per rules

Note*: For all technical problems Please contact following phone numbers : 040-23120311,23120312
(All Calls will be answered 10:30 A.M. to 5:30 P.M. on Working Days).