Vishweshwara Nagar, Mysore - 570008

Application for Admission to Plus One & Plus Two for the Academic Year 2019 – 2020

(Please put a tick in the appropriate columns and fill the application form in block letters)
SSLC ICSE CBSE Marks Marks out of % Photo
Student image
Stream choosen
Student Form NRI
Other State

1. Name of the student First Name
Middle Name
Third Name
Father Name
2. Date of birth 3. Sex 4. Blood group
5. Nationality 6. Mother Tongue 7. Religion
8. Status 9. Email - ID for correspondence
10. Permanent address PIN - Mobile No.
Tick if Correspondence address is same as permanent address
11. Communication / Correspondence address PIN - Mobile No.
12. Name of the last school attended
13. Specify the qualifying examination Registration Number Year 14. Medium of instruction in the last school attended