mLAC - Online / Offline Application form for Academic year 2022-23
Application Number
[Auto generated]
1. General Details of Applicant
Applicant Name
(As per SSLC Marks Card)
Gender
Female
DOB
(As per SSLC Marks Card)
Domicile state
KARNATAKA
ANDAMAN & NICOBAR ISLANDS
ANDHRA PRADESH
ARUNACHAL PRADESH
ASSAM
BIHAR
CHANDIGARH
CHHATTISGARH
DADRA & NAGAR HAVELI
DAMAN & DIU
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU & KASHMIR
JHARKHAND
KERALA
LAKSHADWEEP
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
NCT OF DELHI
ODISHA
PUDUCHERRY
PUNJAB
RAJASTHAN
SIKKIM
TAMIL NADU
TELANGANA
TRIPURA
UTTAR PRADESH
UTTARAKHAND
WEST BENGAL
Student Type
Karnataka State Board
CBSE Board
ICSE Board
Other State
Nationality
Religion
Category
1
2 A
2 B
3 A
3 B
GM
SC
ST
Sub-caste
Aadhaar Number
Physically Challanged
No
Yes
Student Mobile No
Mother tongue
Email ID
Address
Address Pincode
2. Details of Parents / Guardian
Father Name
(As per SSLC Marks Card)
Qualification
Select
Doctoral studies/ Ph.D
Post-Graduate/Master’s Degree
Graduate/ Bachelor’s Degree
Diploma
Completed 10+2
Completed SSLC / Class 10
Completed Primary Education
None
Not attended School
Attended School
Any other
Occupation
Annual Income
Mother Name
Qualification
Select
Doctoral studies/ Ph.D
Post-Graduate/Master’s Degree
Graduate/ Bachelor’s Degree
Diploma
Completed 10+2
Completed SSLC / Class 10
Completed Primary Education
None
Not attended School
Attended School
Any other
Occupation
Annual Income
Guardian Name
Qualification
Select
Doctoral studies/ Ph.D
Post-Graduate/Master’s Degree
Graduate/ Bachelor’s Degree
Diploma
Completed 10+2
Completed SSLC / Class 10
Completed Primary Education
None
Not attended School
Attended School
Any other
Occupation
Annual Income
Parents/Guardian Address (
same as Applicant Address )
Parents/Guardian Address Pincode
Parents/Guardian Mobile No
3. Academic details
Programme Level
PU
Programme
Select
Programme Code
Select
Preferred Subjects (Select 2 subjects)
History
Economics
Political Science
Sociology
Journalism
Optional Kannada
Psychology
Optional English
Physics
Chemistry
Mathematics
Computer Science
Botany
Zoology
Microbiology
Biochemistry
Biotechnology
Psychology
Second Language
KANNADA
HINDI
ADDITIONAL ENGLISH
SANSKRIT
Qualifying Exam Board
SSLC (Karnataka State board)
SSLC (Other State board)
Class X ICSE
Class X CBSE
NIOS
Marks Scored
Total Marks
Percentage
Previous Reg No
Passing Year
Previous College Name
Select
Select