Login for Submission of Annexure

Application No.
Date of birth		1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Submission of Annexure
Fields marked with * are mandatory
Personal Details
Application No.
Name of the Candidate
Course
ACADEMIC RECORD - SECONDARY / 10th STANDARD
	Mark Obtained	Maximum Mark
English*
Total*
Class*
Year of Passing*
ACADEMIC RECORD - SENIOR SECONDARY / 10+2 STANDARD
	Mark Obtained	Maximum Mark
English*
Total*
Class*
Year of Passing*
ACADEMIC RECORD - Degree
	Mark Obtained	Maximum Mark
English
Total*
Class*
Year of Passing*
Board/University Name *
Board/University State *
Examination Regn. No.*
NAME AND ADDRESS OF THE COLLEGE / INSTITUTE WHERE CANDIDATE STUDIED FOR DEGREE
Name*
Address
City*
Pin-Code
State*	select Andaman and Nicobar Islands Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli Daman and Diu Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Lakshadweep Islands Madhya Pradesh Maharashtra Mahe Manipur Meghalaya Mizoram Nagaland Orissa Pondicherry Punjab Rajasthan Sikkim TamilNadu Tripura Uttar Pradesh Uttarakhand West Bengal Kathmandu - Nepal Telangana
Phone No
email [School]
Signature of the candidate and Parent / Gaurdian in hard copy of Annexure is mandatory.