(+91) 94 43 33 14 11
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69/1A, Ultra Nagar, Ultra Arts and Science College Campus, Y.Othakadai, Madurai 625104.

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Application Form

Application Form for UG and Diploma Courses

Course:

Name:

Email:

Father’s Name:

Mother’s Name:

Guardian’s Name:

Date of Birth:

Gender:

Nationality:

Religion:

Community:

Caste:

10th Obtained Marks:

10th Maximum Marks:

12th Obtained Marks:

12th Maximum Marks:

School Name:

Board of Exam:

Group studied in 12th:

Marital Status:

Mother Tongue:

Aadhar No:

Student Mobile No:

Parent Mobile No:

Address:

District:

State:

Pincode:

Hostel Required:

College Transport Required:

Reference: