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Academic Year *

Name of the Applicant *

Gender *

Date of Birth *

Religion *

Cast *

Are you eligible for reservation (SC/ST/OBC/Others) *

Father's Name *

Father's Mobile Number *

Mother's Name *

Mother's Mobile Number *

Nationality *

Marital Status *

Blood Group *

Email *

Phone *

Permanent Address *

Entrance Appeared *

Qualifying Year *

Score Obtained *

Academic Qualifications

SSLC *

Board/University

Year of Passing

Secured Mark

% of Marks

Plus Two *

Board/University

Year of Passing

Secured Mark

% of Marks

Graduation *

Board/University

Course

Year of Passing

Secured Mark

% of Marks

Others

Board/University

Year of Passing

Secured Mark

% of Marks

Other Informations

Additional Academic Information

Work Experience

Proficiency in Art,Sports and Games

Hobbies and Extracurricular Activities

Attach your passport size photograph * JPEG,PNG,GIF. Maximum file size 150 kb

Attach your signature * JPEG,PNG,GIF. Maximum file size 150 kb

Declaration: I certify that the information provided above is true and accurate to the best of my knowledge. I understand that any false information may result in the rejection of my application.

Location
Kunnamangalam, Calicut

Call Us
0495-2802022

Email
snesimsar@gmail.com

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