Vijaya Integrated P U College

Basic Details

ADMISSION NUMBER *

STUDENT PHOTO *

COMBINATION

LANGUAGES

KANNADA
ENGLISH
SANSKRIT
HINDI

STUDENT NAME *

FATHER NAME *

FATHER AADHAR NUMBER

FATHER QUALIFICATION

FATHER OCCUPATION

MOTHER NAME *

MOTHER AADHAR NUMBER

MOTHER QUALIFICATION

MOTHER OCCUPATION

DATE OF BIRTH *

AGE *

GENDER *

MALE
FEMALE

STUDENT DETAILS

HEIGHT(in cms) *

WEIGHT(in kgs) *

BLOOD GROUP *

PHONE NO. 1

PHONE NO. 2

PHONE NO. 3

PERMANENT ADDRESS *

Address Line 1

City

State / Province / Region

Postal Code

Country

SATS NUMBER *

STUDENT AADHAR NUMBER *

BANK ACCOUNT NUMBER *

BANK NAME & ADDRESS *

PLACE OF BIRTH

AREA/PLACE *

TALUK *

DISTRICT *

ANNUAL INCOME *

RATION CARD TYPE

SSLC / 10TH REGISTRATION NUMBER

1 INCOME GENDER

KANNADA/SANSKRIT MARKS *

ENGLISH MARKS *

HINDI MARKS *

MATHEMATICS MARKS *

SCIENCE MARKS *

SOCIAL SCIENCE MARKS *

TOTAL MARKS *

PERCENTAGE *

SCHOOL NAME & ADDRESS *

BOARD IN WHICH STUDENT STUDIED 10TH STD *

ICSC
CBSE
SSLC

STUDENT INCOME CERTIFICATE NUMBER

STUDENT CASTE CERTIFICATE NUMBER

PARENT INCOME CERTIFICATE NUMBER

PARENT CASTE CERTIFICATE NUMBER

Admission Form

Basic Details

STUDENT DETAILS

PLACE OF BIRTH

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