Center Code:

Date of enrolment:

Registration No:

Module (if applicable):

Course:

Project:

Founder/Donor:

Date of Birth:

Gender:
MaleFemaleEpicene

Marital Status:
SingleMarriedDivorced

Religion:
HinduMuslimChristianJainismBuddhismSikhOther

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Type Here:

[/group]

Category:
GeneralSCSTOBC

Physically disabled:
YesNo

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give short description of disability

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Voter IDAadhar CardPan CardPassport (Valid)Admit CardDriving License

Contact no:

Email ID:

Pin Code:

Police Station:

Alternative No:

Landline No:

Demographic type:
UrbanSemi-urbanRuralTribal

Current Address:

Permanent Address:

English:
ReadWriteSpeak

Hindi:
ReadWriteSpeak

Local:
ReadWriteSpeak

Livelihood preferences:

Employed:
YesNo

Salary:

Employment type:
Full-timePart-time

Where employed:

Willing to relocate for job?
YesNo

then-
InState
Out of State

Any computer knowledge?

Highest educational qualification:

Roll no.-

Year of passing:

Board/University name:

Marks %-:

Father's name:

Father's occupation:

Mother's name:

Mother's occupation:

Husband's name:

Husband's occupation:

No. of family members:

Earning members of the family:

Monthly family income:
Less than 2000Between 2000-4000Between 4000-8000More than 8000

BPL card holder:
YesNo

then mention BPL card number:

How did you know about Anudip Foundation?
Walk in admissionReferred by a Anudip studentAdmitted throughMarketing ExecutiveCenter ManagerRegional ManagerFacultyOther reference