etlab | MCA Student Online Application for Academic Year 2023

Personal Details

Candidate Name *

as per SSLC Book

Gender *

Date of Birth *

Age *

Place of Birth *

Mother Tongue

Religion *

Caste *

Aadhar Number *

Blood Group *

Nationality

Category

Admission Quota

Photo *

Maximum size 100KB, type: png

Signature *

Maximum size 30KB, type: png

Admission Details

Admission for *

Academic Year *

Tenth Details

Board *

Year of Passing *

School Name *

Mark/Grade Obtained *

Higher Secondary School Details

Board

Year of Passing

Stream

Register No

School Name

No. of Attempt

Marks Obtained

Maximum Marks

% of Marks

State

Graduation Details

Degree *

Specialization *

University *

Institute Name *

City *

State *

Year of Passing

No. of Attempt

Mark Obtained

Total marks

% of marks

Document Upload

SSLC Certificate *

Maximum size 100KB, type: pdf,png

PLUS TWO Certificate *

Maximum size 100KB, type: pdf,png

Degree Certificate

Maximum size 100KB, type: pdf,png

Degree Marklist

Maximum size 100KB, type: pdf,png

Entrance Admit Card

Maximum size 100KB, type: pdf,png

Entrance Score Card

Maximum size 100KB, type: pdf,png

Contact Details

Present Address

House Name *

Permanent Address [ same as present address ]

House Name *

Street *

Street *

Post office *

Post office *

Pin *

Pin *

District *

District *

State *

State *

Phone No *

Email *

Alternate Phone no

Facilities Required

Hostel Facility

NoYes

Bus Facility

NoYes

Parent Details

Father's Name *

Mother's Name *

Father's \ Guardian's Mobile No *

Mother's Mobile No *

Father's Occupation

Mother's Occupation

Parent Email

Annual Income

Name of Guardian

Relationship with the student

Address of Guardian

Guardian's Phone No

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Declaration

I agree ,The above mentioned facts are true and correct to the best of my knowledge and belief.