Applicant's Name*: Father's Name*: Date of Birth* Day123456789101112131415171819202122232425262728293031MonthJanFebMarAprMayJunJulAugSepOctNovDecYear19501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 Gender* MaleFemale Address* City* Pin Code* [digit* text-843] State* Nationality* Phone No.* [digit* text-189] Qualification* Year of passing* MonthJanFebMarAprMayJunJulAugSepOctNovDecYear1950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 Last Institution Studied* Course* UGPG Payment Mode* ChequeDD Cheque/DD Details Amount* Cheque/DD No* Bank Name* Preferred Courses Courses 1* Courses 2 Courses 3 Preferred Colleges College 1* College 2* College 3*
