mLAC - Online / Offline Application form for Academic year 2023-24
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 )
Parents/Guardian Address Pincode
Parents/Guardian Mobile No
3. Academic details
Programme Level
Programme
Programme Code
Second Language
Qualifying Exam Board
Marks Scored
Total Marks
Percentage
Previous Reg No
Passing Year
Previous College Name