PUC Online Application Portal

Personal Information

First Name *

Middle Name

Last Name *

Father Name *

Mother Name *

Gender *

Male Female

Date of Birth * (DD/MM/YYYY)

Residential Address *

Pincode *

Aadhaar Card Number *

State *

District *

Talukha *

Phone No * Same as WhatsApp number This number should be used for all further communication.

WhatsApp No *

Alternate Contact No

Email

Category and Academic Information

Category *

SC ST OBC GM Other:

10th Medium *

Kannada English Other:

Syllabus Pattern in 10th *

State CBSE ICSE Other:

Last Studied School Name *

Student Photo

Upload Student Photo * (JPG, JPEG, or PNG - Max 5MB)

• Please upload a recent passport-style photo.

• Face must be clearly visible with proper lighting.

• Both ears should be fully visible in the photo.

• Do not use filters, sunglasses, caps, or side-facing pictures.

• Background should be plain and light-colored.

Special Achievements

Special achievement in state level competition

Sports Cultural Academics

Hostel Required? *

Yes No

Declaration

I hereby declare that all the information provided above is true and correct to the best of my knowledge. I understand that any false information may lead to cancellation of my application.

Online Application Form - Bijapur Branch

Branch

Personal Information

Category and Academic Information

Student Photo

Special Achievements

Declaration

Online Application Form - Bijapur Branch

Branch

Personal Information

Category and Academic Information

Student Photo

Special Achievements

Declaration

Application Submitted Successfully!