Email*

Full Name*

Parent's or Guardian's Name *

Date of Birth *

Gender *
MaleFemale

Mobile No.*

Marital Status
Choose oneMarriedUnmarried

Local Address *

Permanent Address *

State*
Select StateAndhra PradeshArunachal PradeshAssamBiharChhattisgarhGoaGujaratHaryanaHimachal PradeshJharkhandKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest Bengal

Preferred City*
Select CityIndorePune

Qualification*
Choose One10th Pass12th PassDiplomaITIBachelor's DegreeMaster's Degree

Graduation Completion Year
Select Year195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030

College Name (Name of the college the student is currently studying in or last attended)*

Annual Family Income(as per Income Certificate)**Amount in INR.

Source of Information -ITEP(Please mention the name of the college/person and specify whether the reference is an alumnus or a current student, etc.)*

Please Upload your Documents in PDF or JPEG Format – 12th Marksheet and Latest Year Passout Marksheet, Aadhar Card, Father’s Aadhar Card, Samagra ID*

*Allowed file types: PDF, JPEG. Maximum file size: 5MB.

Please upload your passport size photo*

*Allowed file types: Any. Maximum file size: 1MB.

Please Upload Your Father’s Income Certificate in PDF or JPEG Format*

*Allowed file types: PDF, JPEG. Maximum file size: 5MB.