Post Graduate Courses (MPT)

Note : Fields marked with * are mandatory

Course applying for *

Other choices in the order of preferences :

Applicant's First Name *

Applicant's Last Name*

Caste / Category *

Nationality *

If Other Please Specify

Permanent Address *

City *

State *

Pin Code *

Tel

Mobile*

Tick Mark If Coorespondence Address is Same as Permanent Address

Correspondence Address*

Tel Mobile*

E-mail*

Date of Birth*

Father's Name *

Father's Occupation

Designation

Contact No.

Mother's Name *

Mother's Occupation

Designation

Contact No.

Educational Qualification of applicant* Exam 10th

College/Institution

Board/University

Year

Subjects

Marks Obtained

Total Marks

Educational Qualification of applicant* Exam 12th

College/Institution

Board/University

Year

Subjects

Marks Obtained

Total Marks

Educational Qualification of applicant* BPTh. - Aggregate

College/Institution

Board/University

Year

Subjects

Marks Obtained

Total Marks

Local Guardian's Name

Relation

Address

Tel

Mobile

University Enrolment No.
(If already Enrolled with Barkatullah University, Bhopal)