UTKAL EDUCATION

APPLICATION FORM FOR ADMISSION

* Admission Type :

*Course :

*Sub Course :

*Course Year :

First Year

Second Year

Third Year

*Applicant's Name: {As Per 10th Certification} :

* Father's Name :

* Mother's Name :

*Gender :

Male

Female

Other

*Date Of Birth :

*Admission Type :

*Email :

*Nationality :

INDIAN

NRI

*Catagory :

*Adhara Card No :

*Employment Status :

EMPLOYED

UNEMPLOYED

*Photo (upload jpg/jpeg/png Max Size 5Mb) :

Address Details

*Permanent Address :

*State :

*City :

*Pin Code :

Education Details

*H.S.C or Equivalent Examination Details :

*Year Of Passing :

*Total Mark :

*Pc(%) Of Mark :

*Division :

*+2 Arts/Science/Commerce Examination Details :

*Year Of Passing :

*Total Mark :

*Pc(%) Of Mark :

*Division :

* UG Examination Details :

*Year Of Passing :

*Total Mark :

*Pc(%) Of Mark :

*Division :

* PG Examination Details :

*Year Of Passing :

*Total Mark :

*Pc(%) Of Mark :

*Division :

Certificate (* upload jpg/jpeg/png Max Size 5Mb)

*Caste Certificate :

*Adhar Card Photo :

*H.S.C or Equivalent Examination Certificate :

*H.S.C or Equivalent Examination Mark Sheet :

*+2 Arts/Science/Commerce Examination Certificate :

*+2 Arts/Science/Commerce Examination Mark Sheet :

*UG Examination Certificate :

*UG Examination Mark Sheet :

*PG Examination Certificate :

*Any Other Examination Certificate :

*Any Other Examination Mark Sheet :

UTKALEDUCATION

ADMISSION GUIDANCE

APPLICATION FORM FOR ADMISSION

Address Details

Education Details

Certificate (* upload jpg/jpeg/png Max Size 5Mb)