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Application Form For Class V-X
Wednesday, 9 Oct 2024
PERSONAL PART
*
Name
Date of Birth
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
*
Nationality
-Select-
Indian
Afghan
albanian
algerian
american
andorran
angolan
antiguans
argentinean
armenian
australian
austrian
azerbaijani
bahamian
bahraini
bangladeshi
barbadian
barbudans
batswana
belarusian
belgian
belizean
beninese
bhutanese
bolivian
bosnian
brazilian
british
bruneian
bulgarian
burkinabe
burmese
burundian
cambodian
cameroonian
canadian
cape verdean
central african
chadian
chilean
chinese
colombian
comoran
congolese
costa rican
croatian
cuban
cypriot
czech
danish
djibouti
dominican
dutch
east timorese
ecuadorean
egyptian
emirian
equatorial guinean
eritrean
estonian
ethiopian
fijian
filipino
finnish
french
gabonese
gambian
georgian
german
ghanaian
greek
grenadian
guatemalan
guinea-bissauan
guinean
guyanese
haitian
herzegovinian
honduran
hungarian
icelander
indonesian
iranian
iraqi
irish
israeli
italian
ivorian
jamaican
japanese
jordanian
kazakhstani
kenyan
kittian and nevisian
kuwaiti
kyrgyz
laotian
latvian
lebanese
liberian
libyan
liechtensteiner
lithuanian
luxembourger
macedonian
malagasy
malawian
malaysian
maldivan
malian
maltese
marshallese
mauritanian
mauritian
mexican
micronesian
moldovan
monacan
mongolian
moroccan
mosotho
motswana
mozambican
namibian
nauruan
nepalese
new zealander
ni-vanuatu
nicaraguan
nigerien
north korean
northern irish
norwegian
omani
pakistani
palauan
panamanian
papua new guinean
paraguayan
peruvian
polish
portuguese
qatari
romanian
russian
rwandan
saint lucian
salvadoran
samoan
san marinese
sao tomean
saudi
scottish
senegalese
serbian
seychellois
sierra leonean
singaporean
slovakian
slovenian
solomon islander
somali
south african
south korean
spanish
sri lankan
sudanese
surinamer
swazi
swedish
swiss
syrian
taiwanese
tajik
tanzanian
thai
togolese
tongan
trinidadian or tobagonian
tunisian
turkish
tuvaluan
ugandan
ukrainian
uruguayan
uzbekistani
venezuelan
vietnamese
welsh
yemenite
zambian
zimbabwean
*
Religion
-Select-
Hinduism
Muslim
Buddhist
Christian
Sikh
Jain
Persian
Other
*
Minority
-Select-
Yes
No
*
Gender
-Select-
Male
Female
Other
Caste
General
SC
ST
OBC-A
OBC-B
Physically Challenged
(if Yes then % of pwd)
No
Yes
Category of PWD
NO
Visual.H
Hearing Impair
Ortho.H
*
Blood Group
-Select-
A+
B+
AB+
O+
A-
B-
AB-
O-
*
Father's Name
Father's Occupation
Guardian's Name
Mother's Name
Full Address with Pin Code
*
Contact No.
Email ID
Family Annual Income
Aadhar No.
Marital Status
Unmarried
Married
Other Specification
None
BPL
NSS
NCC
ADDRESS FOR COMMUNICATION
House No. / Street
P.O
Word No.
Village / Town
Block
District
P.S
State
PIN
PERMANENT ADDRESS
Same as Communication
House No. / Street
P.O
Word No.
Village / Town
Block
District
P.S
State
PIN
Guardian Contact No.
ACADEMIC PART
University Registration No
& Session
of
(Ex:1234 of 2010-2011)
*
Name of the University
CBPBU
Other University
Name of the College
Year of Passing/Appeared
-Select-
2024
2023
2022
Educational Qualifications
Class
Institute/Board
Subject (S)
Year of Passing
Total Marks
Marks Obtained
% of Marks
Divission/Class
Select
V
VI
VII
VIII
IX
X
H.S.
or Equivalent
Wheather Willing to appear in any entrance test
Yes
*
Wheather Appeared or Passed in Madhyamik/Equivalent
Select
Passed
Appeared
Stream
Board/Institute
Honours Subject
Year of Passing/Appeared
Total Marks in Honours Subject
Marks Obtained in honours Subject
% of Marks in Honours Subject
Divission/Class
Select
B.A.
B.Sc
CBPBU
Select
Geography
Any Other Information
*
Apply in Stream
Select
Science
Arts
Commerce
*
Apply in Class
Select
V
VI
VII
VIII
IX
X
Yes I want to get admission in open category also through admission test, If not selected on the basis of merit.