Recognised by UGC and Distance Education Bureau (DEB)

PG I-Year/PG Diplomas/Certificate Programmes Online Admission Registration Form - 2017-18.
1.Personal Details :
Candidate's Name :
(as per SSC Records/TC/Affidavit)
Father's Name :
(as per SSC Records/TC/Affidavit)
Mother's Name :
(as per SSC Records/TC/Affidavit)
Date of Birth :
Gender :
Marital Status :
Aadhar No:
2.Address for Correspondence :
House No. :
Street/Colony/Village :
Mandal/Town/City :
District :
State :
Pincode :
Mobile No. :    
Email ID :
3.Programme of Study :
4.Medium of Study :
6.Religion :
7.Social Status :
Social Status :
8.Employment Status :
9.Occupation :
Select Occupation :
13.Photo & Signature :

10.Educational Qualifications :
Qualification :  
Mode of Study :
State of Study :  
State of University :  
University :  
Marks Secured Out of   
11.Physically Challenged :
Select :
12.Area of Residence :
5.Study Centre Opted :
Study Center :
I hereby declare that I have read and understood the conditions of eligibility for the programme for which I seek admission I fulfill minimum eligibility condition, and I have provided necessary information in this regard. In the event of any information being found incorrect or misleading my candidature shall be liable to cancellation by the University at any time and I shall not be entitled to refund of any fee paid by me to the University.

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