1.
Online No
(e.g. JWC/B.A./2018-21/1111):
2.
Reg. No (College)
(e.g. 19JWC11111):
3.
Student Name: *
4.
Gender: *
5.
D.O.B.: *
6.
Marital Status: *
10.
Religion: *
11.
Caste/ Community: *
12.
Are you physically Challenged: *
Disability %age
Select (If disabled):
13.
Domicile State: *
15.
ID Type & ID No: *
16.
Highest Qualification: *
ADDRESS & CONTACT INFO
17.
Personal Details: *
Address : (Perm.)*
State : *
District:*
CANDIDATE'S DECLARATION
Declaration
- I have read the rules and regulations of the college and will always abide by them
- The Details provided by me in this application is true, complete & accurate to the best of my knowledge and belief.