Name of the Course:

Diploma in Medical Laboratory Technology (D.M.L.T)Diploma in Hospital & Healthcare ManagementDiploma in AgricultureB.Sc (Hons) in Agriculture BiotechnologyB.Sc (Hons) in AgricultureB.Sc (Hons) in BiotechnologyM.Sc in Agriculture BiotechnologyM.Sc in BiotechnologyMBA Agribusiness Management

Name of the Applicant:

Gender:

MaleFemaleOthers

Category:

GeneralSCSTOBCEWS

Religion:

Nationality:

Address Line 1:

Address Line 2:

District:

Police Station:

Pin Code:

State:

AADHAR Number:

Date of Birth:

Father’s Name:

Mother’s Name:

Email ID:

Candidate’s Phone Number:

Father’s Phone Number:

Mother’s Phone Number:

Qualification of the Candidate:

Class 10th – Board/Council/University:

Subjects/Stream: Year of Passing: Marks Obtained: Grade:

Class 12th – Board/Council/University:

Subjects/Stream: Year of Passing: Marks Obtained: Grade:

Graduation – Board/Council/University:

Subjects/Stream: Year of Passing: Marks Obtained: Grade:

Declaration:

I do hereby declare that all the information given above is correct.