Please fill up the form and click 'SUBMIT'.
Name of Student:
Name of Father:
Postal Address:
Contact No. of Parent/Guardian:
Email Address of Parent/Guardian:
Contact No. of Student:
Email Address of Student:
Category: GEN      SC      ST      OBC      PH     
Name of Examination Year of Passing Name of Board Total Marks Obtained Percentage of Marks
IX %
X %
XI %
Upload Student Photo: (Image size must be less that 1 MB)
Upload Student Signature: (Image size must be less that 1 MB)
By clicking the 'SUBMIT' button you are declaring that the information provided by you
in this format is correct to the best of your knowledge and belief.