Personal Information Applying For * : --Select-- AKTU Entrance Admission Courses Direct Admission Courses Course Category * : --Select-- Check Course Eligibility : --Select-- Full Name * : Mr. Ku. Ms. Father's Name* : Mr. Dr. Er. Mother's Name* : Mrs. Smt. Dr. Date of Birth * : [dd/mm/yyyy] Mobile No.* : Land Line No. :   Gender* : MALEFEMALE Mail ID* : --Select-- @gmail.com @rediffmail.com @hotmail.com @live.com Other Religion* : --Select-- Hindu Muslim Sikh Christian Jain Parsi Caste Category* : --Select-- Un-Reserved OBC SC ST Domicile State* : --Select-- UTTAR PRADESH ANDAMAN AND NICOBAR ISLANDS ANDHRA PRADESH ARUNACHAL PRADESH ASSAM BIHAR CHANDIGARH CHHATTISGARH DADRA AND NAGAR HAVELI DAMAN AND DIU DELHI GOA GUJARAT HARYANA HIMACHAL PRADESH JAMMU AND KASHMIR JHARKHAND KARNATAKA KERALA LAKSHADWEEP MADHYA PRADESH MAHARASHTRA MANIPUR MEGHALAYA MIZORAM NAGALAND ORISSA Other PONDICHERRY PUNJAB RAJASTHAN SIKKIM TAMIL NADU Telangana TRIPURA Uttarakhand WEST BENGAL Whether Kashmiri Migrant : NoYes PERMANENT ADDRESS House No/Flat No* : Mohalla/Landmark*   Village/City* : Tehsil/Thana*   State*   --Select-- UTTAR PRADESH ANDAMAN AND NICOBAR ISLANDS ANDHRA PRADESH ARUNACHAL PRADESH ASSAM BIHAR CHANDIGARH CHHATTISGARH DADRA AND NAGAR HAVELI DAMAN AND DIU DELHI GOA GUJARAT HARYANA HIMACHAL PRADESH JAMMU AND KASHMIR JHARKHAND KARNATAKA KERALA LAKSHADWEEP MADHYA PRADESH MAHARASHTRA MANIPUR MEGHALAYA MIZORAM NAGALAND ORISSA Other PONDICHERRY PUNJAB RAJASTHAN SIKKIM TAMIL NADU Telangana TRIPURA Uttarakhand WEST BENGAL District*   --Select-- BANDA CHITRAKOOT HAMIRPUR JALAUN JHANSI LALITPUR MAHOBA Adilabad Agar Malwa AGRA Ahmedabad Ahmednagar Aizawl Ajmer Ajmer Akola Alappuzha ALIGARH Alipurduar Alirajpur ALLAHABAD Almora Alwar Alwar Ambala AMBEDKAR NAGAR AMETHI Amravati Amreli Amritsar Anand Anantapur Anantnag Angul Anjaw Anuppur Araria Aravalli Ariyalur Arwal Ashoknagar Aurangabad Aurangabad AZAMGARH BADODRA Bagalkot Bageshwar BAGHPAT BAHRAICH Baksa Balaghat Balangir Balasore BALLIA Balod Baloda Bazar BALRAMPUR Balrampur Ramanujganj* Banaskantha(Palanpur) Bandipora Bangalore Rural Bangalore Urban Banka Bankura Banswara BARABANKI Baramulla Baran BAREILY Bargarh Barmer Barnala Barpeta Barwani Bastar BASTI Bathinda Beed Begusarai Belgaum Bellary Bemetara Betul BHADOI Bhadradri Kothagudem Bhadrak Bhagalpur Bhandara Bharatpur Bharuch Bhavnagar Bhilwara Bhind Bhiwani Bhojpur Bhopal Bidar Bijapur BIJNOR Bikaner Bilaspur Bilaspur Birbhum Bishnupur Biswanath Bokaro BOKARO STEEL CITY Bongaigaon Botad Boudh BUDAUN Budgam BULANDSHAHAR Buldhana Bundi Burhanpur Buxar Cachar Central Delhi Chamarajanagar Chamba Chamoli Chamoli Champawat Champhai CHANDAULI Chandel Chandigarh Chandrapur Changlang Charaideo Charkhi Dadri Chatra Chengalpattu * Chennai Chhatarpur Chhindwara Chhota Udepur Chikkaballapur Chikkamagaluru Chirang Chitradurga Chittoor Chittorgarh Churachandpur Churu Coimbatore Cooch Behar Cuddalore Cuttack Dadra and Nagar Haveli Dadra and Nagar Haveli Dahod Dakshin Dinajpur Dakshina Kannada Daman Daman Damoh Dangs (Ahwa) Dantewada Darbhanga Darjeeling Darrang Datia Dausa Davanagere Debagarh Dehradun DELHI Deoghar DEORIA Devbhoomi Dwarka Dewas Dhalai Dhamtari Dhanbad Dhar Dharmapuri Dharwad Dhemaji Dhenkanal Dholpur Dhubri Dhule Dibang Valley Dibrugarh Dima Hasao Dimapur Dindigul Dindori Diu Diu Doda Dumka Dungarpur Durg East Champaran East Delhi East Garo Hills East Godavari East Jaintia Hills East Kameng East Khasi Hills East Nimar East Siang East Sikkim East Singhbhum Ernakulam Erode ETAH ETAWAH FAIZABAD Faridabad Faridkot FARRUKHABAD Fatehabad Fatehgarh Sahib FATEHPUR Fazilka FIROZABAD Firozpur G.NOIDA Gadag Gadchiroli Gajapati Ganderbal Gandhinagar Ganjam Garhwa Garhwal Gariaband Gaurela Pendra Marwahi* GAUTAM BUDH NAGAR Gaya GHAZIABAD GHAZIPUR Gir Somnath Giridih Goalpara Godda Golaghat Gomati GONDA Gondia Gopalganj GORAKHPUR Gulbarga * Gumla Guna Guntur Gurdaspur gurgaon Gurugram(Gurgaon) Gwalior Hailakandi Hamirpur Hanumangarh Harda HARDOI Haridwar Hassan Hathras Haveri Hazaribagh Hingoli Hisar Hnahthial Hojai Hooghly Hoshangabad Hoshiarpur Howrah Hyderabad Idukki Imphal East Imphal West INDORE Jabalpur Jagatsinghpur Jagitial Jaipur Jaisalmer Jajpur Jalandhar Jalgaon Jalna Jalore Jalpaiguri Jammu Jamnagar Jamtara Jamui Jangaon Janjgir Champa Jashpur JAUNPUR Jayashankar Bhupalpally Jehanabad Jhabua Jhajjar Jhalawar Jhargram Jharsuguda Jhunjhunu Jind Jiribam Jodhpur Jogulamba Gadwal Jorhat Junagadh JYOTIBA PHULE NAGAR Kabirdham Kachchh Kaimur Kaithal KAKCHING Kakching Kalahandi Kalimpong Kallakurichi * Kamareddy Kamjong Kamle Kamrup Kamrup Metro Kanchipuram Kandhamal Kangpokpi Kangra Kanker KANNAUJ Kannur KANPUR DEHAT KANPUR NAGAR Kanyakumari Kapurthala Karaikal Karauli Karbi Anglong – East Karbi Anglong – West Karimganj Karimnagar Karnal Karur Kasaragod Kasganj Kathua Katihar Katni KAUSHAMBI Kavaratti Kendrapara Kendujhar Khagaria Khammam Khawzawl Kheda (Nadiad) Khordha * Khowai Khunti Kinnaur Kiphire Kishanganj Kishtwar Kodagu Koderma Kohima Kokrajhar Kolar Kolasib Kolhapur Kolkata Kollam Komaram Bheem Kondagaon Koppal Koraput Korba Koriya Kota Kottayam Kozhikode Kra Daadi Krishna Krishnagiri Kulgam Kullu Kupwara Kurnool Kurukshetra Kurung Kumey Kushinagar Lahaul Spiti LAKHIMPUR Lakhimpur Lakhisarai Latehar Latur Lawngtlai Lepa-Rada Lohardaga Lohit Longding Longleng Lower Dibang Valley Lower Siang Lower Subansiri LUCKNOW Ludhiana Lunglei Madhepura Madhubani MADURAI Mahabubabad Mahabubnagar MAHAMAYA NAGAR MAHARAJGANJ Mahasamund Mahe Mahendragarh Mahisagar MAINPURI Majuli Malappuram Malda Malkangiri Mamit Mancherial Mandi Mandla Mandsaur Mandya Mansa MATHURA MAU Mayiladuthurai* Mayurbhanj Medak Medchal–Malkajgiri MEERUT Mehsana MIRZAPUR Moga Mohali Mokokchung Mon Morbi Morena Morigaon Muktsar Mulugu Mumbai City Mumbai Suburban Mungeli Munger MURADABAD Murshidabad MUZAFFARNAGAR Muzaffarpur Mysore Nabarangpur Nadia Nagaon Nagapattinam Nagarkurnool Nagaur Nagpur Nainital Nalanda Nalbari Nalgonda Namakkal Namsai Nanded Nandurbar Narayanpet Narayanpur Narmada(Rajpipla) Narsinghpur Nashik Navsari Nawada Nayagarh Neemuch Nellore New Delhi Nicobar Nilgiris Nirmal Nizamabad Noklak Noney North 24 Parganas North and Middle Andaman North Delhi North East Delhi North Garo Hills North Goa North Sikkim North Tripura North West Delhi Nuapada Nuh ORAI ORAIYYA Osmanabad Pakke-Kessang Pakur Palakkad Palamu Palghar Pali Palwal Panchkula Panchmahal(Godhra) PANCHSHEEL NAGAR Panipat Panna Papum Pare Parbhani Paschim Bardhaman Paschim Medinipur Patan Pathanamthitta Pathankot Patiala Patna Pauri Peddapalli Perambalur Peren Phek Pherzawl PILIBHIT Pithoragarh Poonch Porbandar PRABUDH NAGAR Prakasam PRATAPGARH Pratapgarh Puducherry Pudukkottai Pulwama Pune Purba Bardhaman Purba Medinipur Puri Purnia Purulia RAEBARELI Raichur Raigad Raigarh Raipur Raisen Rajanna Sircilla Rajgarh Rajkot Rajnandgaon Rajouri Rajsamand Ramanagara Ramanathapuram Ramban Ramgarh RAMPUR Ranchi Ranga Reddy Ranipet* Ratlam Ratnagiri Rayagada Reasi Rewa Rewari Ri Bhoi Rohtak Rohtas Roorki Rudra Prayag Rudraprayag Rupnagar Sabarkantha(Himmatnagar) Sagar SAHARANPUR Saharsa Sahebganj Saiha Saitual Salem Samastipur Samba Sambalpur Sangareddy Sangli Sangrur Sangrur SANT KABIR NAGAR Saran Satara Satna Sawai Madhopur Sehore Senapati Seoni Sepahijala Seraikela Kharsawan Serchhip Shahdara Shahdol Shaheed Bhagat Singh Nagar SHAHJAHANPUR Shajapur SHAMLI Sheikhpura Sheohar Sheopur Shi-Yomi Shimla Shimoga Shivpuri SHOOJI MAHARAJ Shopian SHRAWASTI Siang SIDDHARTH NAGAR Siddipet Sidhi Sikar Simdega Sindhudurg Singrauli Sirmaur Sirohi Sirsa Sitamarhi SITAMARHI SITAPUR Sivaganga Sivasagar Siwan Solan Solapur SONBHADRA Sonipat Sonitpur South 24 Parganas South Andaman South Delhi South East Delhi South Garo Hills South Goa South Salmara-Mankachar South Sikkim South Tripura South West Delhi South West Garo Hills South West Khasi Hills Sri Ganganagar Srikakulam Srinagar Subarnapur Sukma SULTANPUR Sundergarh Supaul Surajpur Surat Surendranagar Surguja Suryapet Tamenglong Tapi(Vyara) Tarn Taran Tawang Tehri Tengnoupal Tenkasi * Thane Thanjavur Theni Thiruvananthapuram Thoothukudi Thoubal Thrissur Tikamgarh Tinsukia Tirap Tiruchirappalli Tirunelveli Tirupattur* Tiruppur Tiruvallur Tiruvannamalai Tiruvarur Tonk Tuensang Tumkur Udaipur Udalguri Udham Singh Nagar Udhampur Udupi Ujjain Ukhrul Umaria Una Unakoti UNNAO Upper Siang Upper Subansiri Uttar Dinajpur Uttara Kannada Uttarkashi Vadodara Vaishali Valsad VARANASI Vellore Vidisha Vijayapura * Vikarabad Viluppuram Virudhunagar Visakhapatnam Vizianagaram Wanaparthy Warangal Rural Warangal Urban Wardha Washim Wayanad West Champaran West Delhi West Garo Hills West Godavari West Jaintia Hills West Kameng West Khasi Hills West Nimar West Siang West Sikkim West Singhbhum West Tripura Wokha Yadadri Bhuvanagiri Yadgir Yamunanagar Yanam Yavatmal YSR Kadapa district Zunheboto Other Pincode* : CURRENT ADDRESS Same as above House No/Flat No* : Mohalla/Landmark*   Village/City* : Tehsil/Thana*   State*   --Select-- UTTAR PRADESH ANDAMAN AND NICOBAR ISLANDS ANDHRA PRADESH ARUNACHAL PRADESH ASSAM BIHAR CHANDIGARH CHHATTISGARH DADRA AND NAGAR HAVELI DAMAN AND DIU DELHI GOA GUJARAT HARYANA HIMACHAL PRADESH JAMMU AND KASHMIR JHARKHAND KARNATAKA KERALA LAKSHADWEEP MADHYA PRADESH MAHARASHTRA MANIPUR MEGHALAYA MIZORAM NAGALAND ORISSA Other PONDICHERRY PUNJAB RAJASTHAN SIKKIM TAMIL NADU Telangana TRIPURA Uttarakhand WEST BENGAL District*   -Select- Pincode* :

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