Grievance Cell Name of the Candidate Father's / Husband's Name Mother's Name Address (Permanent) Address (Melling) Name and Address Local Guardian Email ID Contact No. Death of Birth Nationality Sex MaleFemale Marital Status MarriedUnmarried Caste Religion Blood Group Name of the Institution / Board / University last attendant Registration No. with year of the Institution / Board / University last attendant Present Engagement elsewhere (if any) If Yes, Please State For academic course of study : Nature of course Date of Commencement For Employment : Nature of Job Place Examination Passed:- Madhyamik or its equivalent examination Name of the Board / Council Name of the School District Registration No. Roll No. Year of Passing Full Marks Marks Obtained Higher Secondary or its equivalent examination Name of the Board / Council Name of the School District Registration No. Roll No. Year of Passing Full Marks Marks Obtained Graduation (B. Sc. / B. Com. / B.A.)(Pass Hons) or its equivalent examination Name of the University Roll No. Year of Passing Full Marks Marks Obtained
