Name of the Student *Father’s Name *Father’s Qualification & OccupationMother NameDate of BirthGenderMaleFemaleInter MarksInter H.T. No.Eamcet RankEamcet H.T. No.RegionAUOUSVUOthersReservationGeneralSCSTOBCReligionAadhaarPresent AddressPermanent AddressContact No.1 *Contact No.2Contact No.3Contact No.4WhatsApp No.EmailName of the School studiedName of the Jr. College last studiedAnyone whom you know at MIPER CampusUpload PhotoMaximum filesize: 128 MB. Allowed extensions: jpg, jpeg.Captcha Submit
