| 1. |
Name |
| 2. |
Father's Name |
| 3. |
Date of Birth |
| 4. |
Present Address |
| 5. |
Permanent Address with District |
| 6. |
Caste and sub-caste |
| 7. |
Parent's annual income |
| 8. |
Class studied in the previous year |
| 9. |
Admission for which class |
| 10. |
Name of the School and address where the candidate studied previously |
| 11. |
Signature of the Candidate |
| 12. |
Signature of the Parent |
| |
Note: Should affix (1) passport size Photograph on the Application |