Summer School Application Form

Personal Details

First Name*
Last Name*
Programme Name*
Father's First Name*
Father's Last Name*
Date of Birth*
Gender
Nationality*

Contact Details

Correspondence Address*
City/Town*
District*
State/Province*
Country*
Zip/Postal Code*
Post Office*
Police Station*
Permanent Address* (Same as Corrspondence Address)
City/Town*
District*
State/Province*
Country*
Zip/Postal Code*
Post Office*
Police Station*
Mobile No. (Applicant)*
E-mail address (Applicant)*
Mobile No. (Father)
E-mail address (Father)*

Passport Details

Current Passport Number
Issued Date of Passport
Expiry Date of Passport
Issuing Authority
Place of Issue

Past Qualification Details

Details of 10th/ O Level
Year of Passing
Board
Total Marks
Marks Obtained
% of Marks/CGPA
Details of (10+2) 12th / A Level
Year of Passing
Board
Total Marks
Stream*
Marks Obtained
% of Marks/CGPA
*Medical/Non-Medical/Commerce/Arts
Details of Diploma
Year of Passing
Board/University
Total Marks
Programme Name
Marks Obtained
% of Marks/CGPA
Details of Graduation
Year of Passing
University
Total Marks
Programme Name
Marks Obtained
% of Marks/CGPA
Details of Post Graduation
Year of Passing
University
Total Marks
Programme Name
Marks Obtained
% of Marks/CGPA

Session Applying for

Declaration

I do hereby declare that all the above said information provided by me is true & correct to best of my knowledge & belief.
I agree to all the terms and conditions of summer school programme.
The term(s)/ expression(s) mentioned along with the nomenclature of the programme(s) indicates the specialization/ uniqueness (stream, major, scheme combination, progression option etc.) as the case may be.
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