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Name of Students (BLOCK LETTER)Students Email IDDetails of Higher Education Details of Placement (Type “No” If you are not get any placement)Documents Received Date (DD/MM/YYYY)Caste– Select Caste-GENOBCMOBCST-PST-HSCDomicile State– Select State –Andhra PradeshArunachal PradeshAssamBiharChhattisgarhGoaGujaratHaryanaHimachal PradeshJharkhandKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest BengalMobile No.Aadhaar No.Address (Line 1)Vill/TownP.O.StateDistrict– Select –BaksaBarpetaBongaigaonCacharCharaideoChirangDarrangDhemajiDhubriDibrugarhDima HasaoGoalparaGolaghatHailakandiJorhatKamrupKamrup MetropolitanKarbi AnglongKarimganjKokrajharLakhimpurMajuliMorigaonNagaonNalbariSivasagarSonitpurSouth Salmara-MankacharTinsukiaUdalguriWest Karbi Anglong
Name of Institution Last StudiedAcademic Session– Select Session –2020-212021-222022-23Which Class You Study?– Select Class –H.S. 1st YearH.S.. 2nd YearB.A. 1st SemesterB.A. 2nd SemesterB.A. 3rd SemesterB.A. 4th SemesterB.A. 5th SemesterB.A. 6th SemesterClass Roll No.Are You HS Students? (Both 1st and 2nd Year) Yes No
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