VCTM

Admission Form

Name*

Course*

Category*

Date of birth*

Gender*

Religion*

Fathers name*

Fathers occupation*

Fathers monthly income*

Mothers name*

Mothers occupation*

Mothers monthly income*

Guardian name*

Guardian occupation*

Guardian monthly income*

Local address*

Local phone no*

Local mobile no*

Permanent address*

Permanent phone no*

Permanent mobile no*

Email id*

Zipcode*

Locality*

Adhaar card no*

Nationality*

Exam	Board/University	Year	Roll No	Subjects	Max Marks	Marks Obtained	Percentage
High School *							%
Intermediate *							%
							%
							%
Others							%

Name of the activity	School/disctric/state/national/international level	Rank/Place

Photograph*

* file size should not be more than 100kb

Signature*

* file size should not be more than 50kb

Captcha*