1. Enter your name *

2. Enter your parent/guardian name *

3(a). Enter your address of communication *

3(b). Pincode*

4(a). Whatsapp Number

4(b). Mobile Number *

4(c). Email ID*

5. Date of birth*

6. Gender*
MaleFemaleTransgender

7. Religion

8. Mother Tongue

9. Nationality

10. Board of Examination
State BoardCBSEOthers

11. Name of the school

12. 12th Registration Number *

13. Month & Year of passing *

14. Marks *

Subjects	Marks Obtained
12th Total Marks
Physics
Chemistry
Mathematics
Cutoff Marks#

#(a) Marks in Maths to 50 (b) marks in Physics & Chemistry reduce 50 (c) Cut of Marks: (a)+(b)

15. NATA Registration Number

16. NATA Marks

17. Parents Details

Parent	Details	Office Contact Details
Father:	Name: Occupation: Annual Income:	Phone Number Mobile Number
Mother:	Name: Occupation: Annual Income:	Phone Number Mobile Number

18. List the outstanding sports/cultural achievements, scholarships recieved, prizes/honors won etc.

19. Height (cms)

20. Weight (kgs)

21. Blood Group

22. Aadhar Card No

23. Attachments
(i). Copy of Transfer Certificate :
(ii). Copy of 10th Marksheet :
(iii). Copy of 12th Marksheet :
(iv). Copy of Community Certificate :
(v). Passportsize Photograph :

Station

Date

I declare that the information furnished in above is true and correct to the best of my knowldge.