Name of Course - Select -ESPDESPD+MSD11TH-12THB.COMB.SCSSCBANKRAILWAYGOVERNMENT EXAMDEFENCEName Gender -Select-MaleFemaleTransgenderDate of Birth: Marital Status - Select -MarriedUnmarriedWidowDivorceFather's/Husband’s Name Contact Number Mother's Name Local Guardian’s Name Contact Number Family’s Annual Income Nationality Local Address:Address District State Pin Code Contact Number E-Mail Mobile Number Tick if Local and Permanent address is same Tick if Local and Permanent address is samePermanent Address:Address District State Pin Code Phone Number Identification Mark Details of Examination Passed:10 Board/University 12th Board/University Graduation /University Post Graduation /University If any other Board/University 10th Year of Passing 12th Year of Passing Graduation Year of Passing Post-Graduation Year of Passing If Any Other Year of Passing 10th Subjects Studied 12th Subjects Studied Graduation Subjects Studied Post-Graduation Subjects Studied If Any Other Subjects Studied 10th Divison (with%age) 12th Divison (with%age) Graduation Divison (with%age) Post-Graduation Divison (with%age) If Any Other Divison (with%age) Upload 10th Documents Upload 10th Documents Upload 12th Documents Upload 12th Documents Upload Graduation Documents Upload Graduation Documents Upload Other Documents Upload Other Documents Upload Post-Graduation Documents Upload Post-Graduation Documents Candidates Photograph Choose File (PNG, JPG) Aadhar No Aadhar Front Image Choose File Aadhar Back Image Choose File Select Proof - Select -Voter CardAadhar CardElectricity BillBank PassbookAddress Proof attachment Choose File I hereby, declare that the information given in the form is true to the best of my knowledge and belief. I undertake to accept and abide by the rules of Xcellence Valley and all the decisions of the admission committee in regard to any admission. I further declare that I am not involved in any criminal case and/or no such case is pending against me in any court of law. I have read and agree to the Terms and Conditions.Enter Amount Submit Form
