Application / Interest Form

Please provide accurate information. Required fields are marked with *.

1. Student Information

Surname *

First Name *

Full Name on Certificate *

Father's Name *

Mother's Name *

Date of Birth *

Age (Years)

Gender *

Contact Number *

Email *

House No.

Street / Colony

Village / City *

Landmark

Block (Taluka) *

District *

Pin Code *

2. Parent's Information

Father's Occupation *

Mother's Occupation *

Father's Contact No. *

Mother's Contact No.

Parent's Email

3. Academic Information

School Name *

School Address

Block (Taluka)

District

Pin Code

Class (Standard) *

Division

Marks (Per Subject)

Subject	Obtained	Max
Marathi
English
Mathematics
Science
Social Science

Total Marks

Percentage

4. Aadhaar Information

Aadhaar No. *

Upload Aadhaar Card

Upload Marksheet

5. Family's Agricultural Information

Do you have agriculture land? *

Type of farming practiced

Own land cultivation Cultivate on share / lease Given land on share / lease

Total land (Acres)

Irrigated land (Acres)

Rainfed land (Acres)

Source of Water

Crops cultivated

Livestock *

If livestock, which type?

6. Parent Consent Form

Parent Name *

Relationship *

Student Name *

Student's Class & School *

Address *

Contact Number *

I confirm that the above information is true and I consent to my child participating in the programme.

Cancel