APPLICATION FORM

PERSONAL INFORMATION
Scheme Type* : Category* :
Course* : Institute Location* :
Name of the Candidate with Surname* :
(Only Upper case letter)
Father's Name* :
(Please do not use any prefix such as
Mr. or Shri. or Prof. or Dr. etc.)
Date of Birth* :
Gender* :
Aadhaar Card Number* : EMail ID* :    
Bank Account Number* :   Branch* :  
IFSC Code* :   Registration Number* :
(Allotment Application no)
 
Blood Group* : Medium* :  
ADDRESS
State : District:
Block/Mandal : Village :
House/Door Number : Pin Code* :
Mobile Number* : Alternative Phone Number :
UPLOAD DOCUMENTS
*All the scaned documents should be in *.jpg OR *.jpeg format and size not be more than 100KB
Passport size Photograph* :   Signature *:  
Date of Birth Proof (SSC Certificate)* :   Intermediate Certificate* :  
Any Degree Certificate* :   AP NTR Vidyonnathi scheme allotment order(letter)* :  
Aadhar Card* :   Bank Passbook(Front page only)* :  
Income Certificate : Caste Certificate :
   I hereby declare that, I have furnished correct information to the best of my knowledge. If anything is found at any stage will be liable for cancellation of seat with recovery of financial implication.
Submit