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ADMISSION FORM
Student Details
Student Name
*
:
Date Of Birth
*
:
Gender
*
:
Female  
Male
Religion
*
:
Caste
*
:
Sub-Caste
*
:
Address
*
:
Tel/Mobile No.
*
:
Pin Code-landline No. OR Mobile No
Photo
*
:
Parent Details
Father Name
*
:
Mother Name
*
:
address
*
:
Parent's Annual Income
*
:
Income Certificate Applies?
*
:
Yes
No
Previous School/College Details
School/College Name
*
:
School/College Address
*
:
Previous Examination Passed
*
:
Register Number
*
:
Year and Month
*
:
-- SELECT PASSED OUT YEAR --
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
-- SELECT PASSED OUT MONTH --
1
Jan
2
Feb
3
Mar
4
Apr
5
May
6
Jun
7
Jul
8
Aug
9
Sep
10
Oct
11
Nov
12
Dec
Medium
*
:
-- SELECT MEDIUM --
English
Kannada
Hindi
Urdu
Telgu
Subjects Studied
Marks Obtained
1
st
Language
*
:
-- SELECT 1
ST
LANGUAGE --
Kannada
English
Hindi
Sanskrit
Urdu
Telgu
2
nd
Language
*
:
-- SELECT 2
nd
LANGUAGE --
Kannada
English
Hindi
Sanskrit
Urdu
Telgu
3
rd
Language
*
:
-- SELECT 3
rd
LANGUAGE --
Kannada
English
Hindi
Sanskrit
Urdu
Telgu
Science
*
:
Mathematics
*
:
Social Science
*
:
Extra Curricular Activities
*
:
Languages and Combination Offered to Study in the PU Course
Science
Commerce
PUC Medium
*
:
-- SELECT MEDIUM --
English
Languages
*
:
-- SELECT LANGUAGE --
English
-- SELECT LANGUAGE --
Kannada
Hindi
Sanskrit
Optional Subjects
*
:
-- SELECT 4
TH
SUBJECT --
Statistics
Biology
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