| 1. |
Enter your register number (last studied diploma or +2): |
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| 2. |
Name of the Applicant : |
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| 3. |
Select Course Applied : |
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| 4. |
Gender : |
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| 5. |
Community : |
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| 6. |
Father's Name / Guardian's Name : |
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| 7. |
Student Phone Number : |
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| 8. |
Parent's Phone Number : |
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| 9. |
Address : |
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| 10. |
Reference by whom: |
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| 11. |
Last studied course and college address: |
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