I PUC Online Admission Form

Name of the Student (in capital letters) *

Name of the Father *

Name of the Mother *

Date of Birth *

Contact No. *

Whatsapp No. *

Your Email *

Postal Address with Pincode *

State *

District *

Taluk *

Mother Tongue *

SATS Number

SSLC Reg. No. *

Last Institution Postal Address *

Select Stream *
—Please choose an option—ScienceCommerceArts

Select Combination*
—Please choose an option—PCMBPCMCPCMEPCMS

Select Combination*
—Please choose an option—SCBASEBAECBA

Select Combination*
—Please choose an option—HEPS

Select Language *
KannadaHindiSanskrit

Religion *

Marks obtained in Preparatory/Final examination in X th *

Marks obtained *

Maximum Marks *

Do You Require Hostel *
YesNo

I agree that all the detailed submitted above are true to the best of my knowledge.