Form No.       
 
 Registration No.
 

1. Programme Applied For :

2. Campus :     


3. Personal Details

Name:  
Father's Name:  
Date Of Birth: Gender:
Category: Nationality:

4. Contact Details

Correspondence Address:
E-mail:   Phone No: Mobile No:  

5. Educational Qualifications

Examination Passed Name of The Stream School / College and Board / University Year of Passing Subject Studied Marks Obtained Maximum Marks % of Marks
10th
12th
 Diploma
Graduation
Post Graduation

6. From where did you come to know about Jagan Nath University.

                   

Date: Saturday, December 3, 2016

  


Admit Card

Course Applied For :
Registration No/Roll No.:
Test Centre : Date : Time :
Name:
Father's Name:
E-mail: Mobile No: