Candidate Name *(Name as recorded in the Matriculation/Secondary Examination Certificate)

Email ID *

Mobile Number *

Whatsapp Number *

Date of Birth * Applicant must be born before 01 August 2006.

Father's Name *

Mother's Name *

Religion *

Category * Select Category General Other Backward Classes Scheduled Castes Scheduled Tribes Economically Weaker Sections

Are you a person with a disability ? * Select Yes No

If yes, Give details

Whether you have previously been enrolled in any of our academy's courses or programs. * Select Yes No

If yes, Give details

Gender * Select Gender Male Female Other

Blood Group * Select Blood Group A+ A- B+ B- O+ O- AB+ AB- Other

Marital Status * Select Marital Status Single Married Divorced Widow

Guardian Name *

Guardian Mobile Number *

Annual Income of Family *

Aadhar Number *

Preferred Exam Center * Select Exam Center Ernakulam Perinthalmanna Calicut Kannur Trivandrum New Delhi Kavarati Thrissur Ponnani Nadapuram

Permanent Address

House Name *

City/Town/Village *

Post Office *

District * Select District Thiruvananthapuram Kollam Pathanamthitta Alappuzha Kottayam Idukki Ernakulam Thrissur Palakkad Malappuram Kozhikode Wayanad Kannur Kasaragod UT of Lakshadhweep

Pin code *

Niyamasabha Constituency Name* Select Constituency Name

Panchayat/Municipality *

Residential address

House Name *

City/Town/Village *

Post Office *

District * Select District Thiruvananthapuram Kollam Pathanamthitta Alappuzha Kottayam Idukki Ernakulam Thrissur Palakkad Malappuram Kozhikode Wayanad Kannur Kasaragod UT of Lakshadhweep

Pin code *

Upload Documents

Candidate's Photo *
Upload a clear passport-size color photo (4.5cm x 3.5cm). Only JPG, JPEG, PNG allowed. File size must be below 3 MB.

Candidate's Signature * Upload a clear photo of signature (3.5cm x 1.5cm). Only JPG, JPEG, PNG allowed. File size must be below 3 MB.

Academic Details *