Enrollment Form- 2024 (To be filled in Capital Letters Only)
	Candidate Name*	As in candidate class X mark sheet
	Father Name*	As in candidate class X mark sheet
	DOB* * * (DD/MM/YYYY)	/  /
	Gender*	Male Female Transgender
	ABC ID:	(Academic Bank of Credits-Digilocker)
	Category	Select General Schedule Caste Schedule Tribe Backward Class Other Backward Class Person with Disability *
	State *	Select Andaman and Nicobar Islands Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadar and Nagar Haveli Daman and Diu Delhi-National Capital Territory GANDAKI Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir JANAKPUR Jharkhand Karnataka Kerala Lakshadweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Puducherry Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal
	District*
	Vill/Town/City*
	Email Id* *	*
	Whatsapp Number
	Program Discipline*	Select Agricultural Sciences Commerce, Business Management & Economics Computer Science & Applications Education Engineering and Technology Humanities and Social Sciences Law & Legal Studies Life Sciences Pharmacy Physical Education & Sports Physical Sciences
	Program*	Select Program
	Hostel Required*	Yes No
	Have You Qualified any entrace test?*	Yes No
	Mobile No* *
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