Application Form

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Name

Father's Name

Father's Occupation

Mother's Name

Mother's Ocupation

Local Gaurdians Name

Local Gaurdians Phone No

Permanent Address

Parent Phone No

Date Of Birth

Place of Birth

Monthly Income

Whether already Enrolled in Lucknow/Faizabad University, Yes Or No ?

Nationality

Married/Unmarried

Whether SC/ST/Backward/General/Minority Candidate ?

Contact

Period of the Residence of Uttar Pradesh

Whether in Sevices ?

last College Form Where XII Or equivalent Exam Passsed

Name of Examination Board/University Year Subjects Marks Obtained Percentage/Div
High School
Intermediate
B.A.,B.Sc.,B.Com And Others
M.A., M.Sc., M.Com And Others
Any Others Courses

Subject Selected
General Subject Offered