Indira Gandhi Group of Institutions

COLLEGE

FATHER

CONTACT NO

WHETHER APPLYING FOR LATERAL ENTRY

REFFERED BY

FATHER QUALIFICATION

FATHER OCCUPATION

Degree Name

QUOTA

MOTHER

CONTACT NO

COURSE APPLIED

BRANCH APPLIED ( PRIORITY 1 )

MOTHER QUALIFICATION

MOTHER OCCUPATION

BRANCH APPLIED ( PRIORITY 2 )

BRANCH APPLIED ( PRIORITY 3 )

ANNUAL FAMILY INCOME ( Rs. )

APPLICANT'S NAME

LOCAL GUARDIAN

CONTACT NO

DOB

GENDER

GUARDIAN RELATIONSHIP

BLOOD GROUP

NATIONALITY

WHETHER PHYSICALLY HANDICAPPED

RELIGION

CATEGORY/COMMUNITY

DESCRIPTION (IF YES)

RESERVATION APPICABLE

MOBILE

WHETHER DEPENDENT OF EX-SEVICE MAN

WHATSAPP NO

LAND PHONE NO

DESCRIPTION (IF YES)

EMAIL

AADHAR NO

WHETHER MEMBER OF NSS / NCC

COMMUNICATION ADDRESS

DESCRIPTION (IF YES)

PINCODE

REMARKS ( IF ANY )

PERMANENT ADDRESS

PINCODE

PROPOSED RESIDENCE AFTER ADMISSION

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HOSTEL

COLLEGE BUS

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EDUCATIONAL DETAILS

DEGREE NAME

SCHOOL / INSTITUTION

BOARD / UNIVERSITY

REGISTER NO

MONTH OF PASSING

YEAR OF PASSING

MARKS (%)/GRADE

ADD

Sl No	DEGREE NAME	SCHOOL / INSTITUTION	BOARD / UNIVERSITYN	REGISTER NO	MONTH OF PASSING	YEAR OF PASSING	MARKS (%)/GRADE	Action

NEET DETAILS

Name of Examination

Authority

Application No

Roll No

Rank No All India (Overall)

KEAM DETAILS

Year

Roll No

Rank No

Date of Allotment Memo

APPLICATION FEE DETAILS

NB : IF YOU HAVE PAID APPLICATION FEES ONLINE PLEASE PROVIDE THE DETAILS.

APPLICATION FEE

TRANSACTION ID / RECEIPT NO

RECEIPT DATE

Payment Type

Bank

Cash

UPI

DECLARATION

I do here by declare that I am an INDIAN citizen and all information furnished above are true and I will obey rules and regulations of the institution, if I am admitted. I shall submit all certificates and documents in original at the time of admission , failure of which my admission will be liable to cancellation.

I Agree

NB : Fees once paid shall not be refunded under any circumstances.

APPLICATION FORM

EDUCATIONAL DETAILS

NEET DETAILS

KEAM DETAILS

APPLICATION FEE DETAILS

DECLARATION