mLAC - Online / Offline Application form for Academic year 2024-25
Application Number
[Auto generated]
1. General Details of Applicant
Applicant Name (As per SSLC Marks Card)
Gender
DOB (As per SSLC Marks Card)
Domicile state
Student Type
Nationality
Religion
Category
Sub-caste
Aadhaar Number
Physically Challanged
Student Mobile No
Mother tongue
Email ID
Address
Address Pincode
2. Details of Parents / Guardian
Father Name (As per SSLC Marks Card)
Qualification
Occupation
Annual Income
Mother Name
Qualification
Occupation
Annual Income
Guardian Name
Qualification
Occupation
Annual Income
Parents/Guardian Address ( same as Applicant Address )
Pincode
Parents/Guardian Mobile No
3. Academic details
Course Type
Course Name
Combination
Second Language
Qualifying Exam Board
Marks Scored
Total Marks
Percentage
Previous Reg No
Passing Year
Applicant Studied at mLAC?:
Previous College Name
Referral Type
Referred By
If referred by student, register number
Alumni Course
Alumni Graduation Year
Name as in Aadhar
Blood Group
Height (Feet)
Weight (Kg)
Percentage of disability
Scholarship Availed
Admission Number I PU
Admission Number II PU
Minority
BPL beneficiary
BPL beneficiary number
Previous Year Attendance (%)
Application Number
Interest In extracurricular
Participation in Sports
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Interest in science
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