• Personal Details
  • Course Choice
  • Payment Details

Personal Details

Full Name of Applicant

Father's Name

Mother's Name

Date of birth

Personal Email ID

Personal Mobile Number

Father's/Guardian Email ID

Father's Mobile Number

Parent's Annual Income

Religion

Blood Group

Category

Gender

State of Domicile

Permanent Address

Address Line 1

Address Line 2

Country

State

District

City

Pin Code

Telephone with area code

Upload Photo (Less then 300kb)

Photo

Course Choice

Select Course

10th Details

Board/University

Year of passing

Roll Number

School/College Name

Max Marks/CGPA

Obtained Marks/CGPA

Percentage

Grade/Division

12th/Deploma Details

Board/University

Year of passing

Roll Number

School/College Name

Max Marks/CGPA

Obtained Marks/CGPA

Percentage

Grade/Division

Graduation

Board/University

Year of passing

Roll Number

School/College Name

Max Marks/CGPA

Obtained Marks/CGPA

Percentage

Grade/Division

Qualifying Exam

Qualifying Exam Name

Qualifying Exam Rollno.

Qualifying Exam all India Rank

Qualifying State Rank

Branch Choice

Candidate Category

Payment Details

Payment through NEFT
Detail of GIMT, Kanipla (Kurukshetra) Bank Name: Punjab National Bank Branch: PNB Ratgal (Kurukshetra) Account Number: 3287000100545715 IFSC Code: PUNB0328700

Candidate’s Payment Detail

Bank Name

Transaction ID

Date of Transaction:

Cheque Number:

DD Number:

Amount: Rs. 200/-