LAXMI NARAYANA POLYTECHNIC COLLEGE : DHARMAPURI

ONLINE APPLICATION FORM

* Must fill fields

Course

Year of Joining

Candidate Name:

Father's Name:

Mother's Name:

Address:

Gender

Student Aadhaar No:

Mobile Number:*

Whatsapp Number:

Date of Birth:

Age:

Nationality:

Community:

Caste:

Examination Passed:

Month & Year of Passing:

Reference:

Marks Obtained:

Subject	Maximum Marks	Marks Obtained
TAMIL	100
ENGLISH	100
	100
	100
	100
	100
Total