Father’s Name*:

Mother’s Name*:

Gaurdian’s Name*:

Date Of Birth*:

Academic Qualification*:

Mobile Number*:

E mail ID*:

Permanent Address*:

Current Address*:

Aadhaar Number*:

I hereby declare that the above statement & information are correct to the best of my knowledge & belief & I completely understand that any information furnished above, if proved incorrect or false will render me liable for any consequences as may be prescribed in law or otherwise warrented.