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Name of the Student:
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Name of the parish:
Name of the School:
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Father's Name:
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Father's Job:
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Mother's Name:
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Mother's Job:
Address:
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State:
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Andra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
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Himachal Pradesh
Jammu and Kashmir
Jharkhand
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Nagaland
Orissa
Punjab
Rajasthan
Sikkim
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West Bengal
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District:
---Select---
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Land Phone:
Mob:
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Plus TWO Syllabus:
ICSE
CBSE
State
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Total Percentage of Mark
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Interested Courses:
B-Tech-CSE
MCA
BSC
BBA
MBA
B-COM
Other Course:
Which State Candidate Likes to Study:
KERALA
TAMILNADU
KARNATAKA
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Name of brothers or Sisters who is studiying for digree final year:
