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CASUAL APPLICATION FORM
Student Information
Search on University Registration No.:
Search on College Roll No.:
Search on University Roll No.:
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First Name
★
Last Name
★
Sex
★
Male
Female
Third gender
Present Address
★
Permanent Address
City
Pincode
State
Country
Land Line No.
Mobile No.
★
Email ID
Date of Application
★
(dd/mm/yyyy)
Date of Birth
★
(dd/mm/yyyy)
Univ. Reg.& Roll No.
★
Is Handicapped?
No
Yes
Social Category
★
General
SC
ST
OBC-H
OBC-A
OBC-B
General - Disabled
SC - Disabled
ST - Disabled
OBC-H - Disabled
OBC-A - Disabled
OBC-B - Disabled
Religion
★
Aadhar No.:
Blood Group:
Bank Name:
Bank A/c No.:
IFS Code:
Identity Mark:
Father's Name:
★
Full Address:
Contact No.:
★
Email ID:
Mother's Name:
Local Guardian:
Is Active?
★
No
Yes
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Name
Mobile No.
Email Id
Father's Name
University Reg. No.
Name
Mobile No.
DOB
Father's Name
University
Reg. No.
University
Roll No.
Admission No.
Roll No.
Applied for Course
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