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

Email ID *

Mobile Number *

Whatsapp Number *

Date of Birth *

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

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

Guardian Name *

Guardian Mobile Number *

Annual Income of Family *

Aadhar Number *

Preferred Exam Center * Select Exam Center Perinthalmanna Calicut Kannur Trivandrum New Delhi Kavarati

Permanent Address

House Name *

City/Town/Village *

Post Office *

District * Select District Kasaragod Kannur Wayanad Kozhikkode Malappuram Palakkad Thrissur UT of Lakshadhweep

Pin code *

Residential address

House Name *

City/Town/Village *

Post Office *

District * Select District Kasaragod Kannur Wayanad Kozhikkode Malappuram Palakkad Thrissur UT of Lakshadhweep

Pin code *

Upload Documents

Candidate's Photo *
Upload a clear passport-size color photo (4.5cm x 3.5cm).Selfies or group photos will not be accepted, file size must be below 3 MB.

Candidate's Signature * Upload a clear photo of signature (3.5cm x 1.5cm), file size must be below 3 MB.

Academic Details *