APPLICATION FORM Please enable JavaScript in your browser to complete this form.Choose the Current CourseANMGNMPersonal DetailsPlease Enter all correct information in the fields.Full NameFirstMiddleLastPlease Enter the Full Name HereFather/Guardian Name FirstMiddleLastAadhaar Number *Mother NameCasteSub-CasteCandidate Phone Number (Bank/Aadhar Linked) *Father / Guardian / Husband Mobile Number *EmailCurrent AddressPermanent AddressMarital StatusMarriedUnMarriedAfter Marriage NameR u have any Physical Disability ?Blood GroupEducation Details :SSC Passing Year *SSC Total Marks *HSC StreamARTScienceCommerceOther QualificationANMOpen UniversityNoneHSC Passing Year *HSC Total Marks *Choose BelowHostellerDay ScholarBank DetailsPlease Enter Correct Bank Details...Name of the BankBranchAccount Number (Bank/Aadhar Linked)IFSC CodeBank Passbook Click or drag a file to this area to upload. Max. File size 256 KB.DocumentsFile should be under 256KB.Upload Photo Click or drag a file to this area to upload. Max. File size 256 KB.Upload Sign Click or drag a file to this area to upload. Max. File size 256 KB.Caste Certificate NumberIssued ByUpload Caste Certificate Click or drag a file to this area to upload. Max. File size 256 KB.Caste Validity NumberIssued ByUpload Caste Validity Click or drag a file to this area to upload. Max. File size 256 KB.Total IncomeIncome Certificate NumberIssued ByUpload Income Certificate Click or drag a file to this area to upload. Max. File size 256 KB.Domicile Certificate NumberIssued ByUpload Domicile Certificate Click or drag a file to this area to upload. Max. File size 256 KB.Leaving Certificate * Click or drag a file to this area to upload. Max. File size 256 KB.SSC Marksheet * Click or drag a file to this area to upload. Max. File size 256 KB.SSC Board Certificate Click or drag a file to this area to upload. Max. File size 256 KB.HSC Marksheet Click or drag a file to this area to upload. Max. File size 256 KB.HSC Board Certificate Click or drag a file to this area to upload. Max. File size 256 KB.Aadhar Card * Click or drag a file to this area to upload. Max. File size 256 KB.Birth Certificate Click or drag a file to this area to upload. Max. File size 256 KB.Gap Certificate (if Any) Click or drag a file to this area to upload. Max. File size 256 KB.Father Death Certificate (if) Click or drag a file to this area to upload. Max. File size 256 KB.Marriage Certificate (if) Click or drag a file to this area to upload. Max. File size 256 KB.Ration Card Click or drag a file to this area to upload. Max. File size 256 KB.Other Qualification 1 Click or drag a file to this area to upload. Max. File size 256 KB.Other Qualification 2 Click or drag a file to this area to upload. Max. File size 256 KB.Checkboxes *I agree , all data which I provided is Accurate and Legel with Institute Terms and Conditions.Submit
