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Form ID Number =


Eg: If ID=000004378, write as 4378. (save the number for future reference)

First Name

 

Middle Name


SurName

 

DOB

 

Village/Street


H.No


PO


District

 

Pin

 

State


Phone


Mobile

 

Email.


Last School Name



Last School Address


Seeking Admission to.

 

Hostel (Tick Mark if Opted Yes)