DR. C.V. RAMAN UNIVERSITY

Student Admission Form

Your Refrence number*

Addmission Type*

Batch*

Branch*

Student's First Name*

Student's Middle Name

Student's Last Name*

Father's First Name*

Father's Middle Name

Father's Last Name*

Mother's First Name*

Mother's Middle Name

Mother's Last Name*

Gender*

Nationality*

Category*

Residence*

Minority*

Handicap*

Date of Birth*

Religion*

Blood Group

Tel. Number

Mobile Number*

Email id*

Same as Permanent

Permanent Address*

Country/State*

District*

City*

Pincode*

Temporary Address*

Country/State*

District*

City*

Pincode*

EXAM	Board of University	Year of Passing	Subject	Marks
10th*
12th*
Diploma
Graduation
post Graduation
PET/CAT/AIEEE/PRE

	Age (in Year)	Qualification	Profession	Organization	Designation
Father/Husband
Mother

Father/Husband Email

Mother Email