::Exam Information::
Select campus in which you want to get the admission :*	----Select Campus---- BHOPAL CAMPUS KHANDWA CAMPUS REWA CAMPUS DATIA CAMPUS
Course Level*		Course name :*	Select Course name
		शैक्षणिक योग्यता MLIS पाठ्यक्रम के लिए :- मान्यता प्राप्त विश्वविद्यालय से BLIB / BLIS उपाधि
NOTE :- PG 1 Year Courses : These courses only for those students who have completed their 4 year graduation as per NEP (New Education Policy). (Fill separate form if you are applying more than one course in same course level) Click here

::General Information::
Did you appear for CUET-PG Exam ? : YESNO
Candidate's First Name (As per 10+2 Marksheet):*		Last Name/SurName:*
Gender*	-Select- Male Female Transgender	Date of Birth(DD/MM/YYYY):*
Category *	-Select- UR OBC SC ST EWS	Father's Name:*
Domicile of Madhya Pradesh*	-Select- Yes No	If Other then MP then select State                                          Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Goa Gujarat Haryana Himachal Pradesh Jammu & Kashmir Jharkhand Karnataka Kerala Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Punjab Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Andaman & Nicobar Chandigarh Dadra & Nagar Haveli Daman & Diu Delhi Lakshadweep Pondicherry Other Telangana Ladakh
Sub Category:	-None- Handicapped J&K Migrants Army Quota (Self)	Student belongs to *	--Select-- RURAL URBAN

::Address::

House No/Village:* Colony/Post office:*   City/Tehsil:* District:*   State:* Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Goa Gujarat Haryana Himachal Pradesh Jammu & Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Punjab Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Andaman & Nicobar Chandigarh Dadra & Nagar Haveli Daman & Diu Delhi Lakshadweep Pondicherry Other Telangana Ladakh Pincode:*

::Other Details::
Phone Number(Off./Resi.)(With STD Code)	Mobile Number*	. Email Id *
	**Do not use Prefix '0' or '+91' In mobile Number

UPLOAD PHOTO WITH SIGNATURE OF STUDENT
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कृपया फोटो के साथ सिग्नेचर भी अटैच करें सिग्नेचर के अभाव मैं आपका फॉर्म निरस्त किया जा सकता है इसकी ज़िम्मेदारी स्वयं आपकी होगी

::Checklist for Enclosures(To be produced at the time of Counseling)::
High School (10th) marksheet *		10+2 marksheet or Equivalent *	All Graduation Marksheet
Domicile Certificate (if from MP)	EWS/Caste Certificate	In Service Documents of Army/Handicapt/J&K Migrants certificate
For MCA Please Tick Mathematics as a Subject at      10+2 Level                               Graduation Level

Declaration

I hereby declare that the information given in this application is true and correct to the best of my knowledge and belief. In case any information given in this application proves to be false or incorrect, I shall be responsible for the consequences.

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