University of Patanjali

Application Form Session:2023-2024

Application Add * fields are mandatory

Select Course *

Name(As Per Matriculation)*

Father's Name*

Mother's Name*

Guardian's name in case of orphan

Date Of Birth(As Per Matriculation)*

DOB (In Words)*

Age on 31st July(Current Year) *

Nationality*
Other Indian

Birth Place*

District

State

Caste*

Gender*
Male Female

Marital Status
Single Married Divorced

Spouse name if not divorced

Whether Physically Challenged
Yes No

Visible identification marks

Occupation of Father & Mother/Guardian/Spouse(if married)

Parental Annual Income

Participation

NSS Yes No
NCC(A,B,C) Yes No
SPORT-(mention name)

Select Religion*

Aadhar Card No.*

Correspondance Address

Select State *

Select District *

City *

Police Station *

Pincode *

If Permanent Address same as Correspondance Address

Permanent Address

Permanent Address *

Select State *

Select District *

City

Police Station

Pincode

Applicant Email*

Landline No.

Applicant WhatsApp No.*

Local Guardian name(if applicable)

Address

Relation

Mobile No.

E-mail

Name of Board/University of qualifying examination passed/persuing*

Detail of repeat/supplementary Exam in qualifying Exam(if any)

Education Qualification: (Starting From 10th)*

S.No	Education	Board/University	Passing Year	Total Mark	Grand Total	Marks(%)

Gap Year if Any
No Yes

Have you ever been punished for any in disciplinary activity
Yes No

High School Marks Sheet
Yes No

High School Certificate
Yes No

Intermediate Marks Sheet
Yes No

Intermediate Certificate
Yes No

Graduation Marks Sheets
Yes No

Aadhaar Card
Yes No

Caste Certificate
Yes No

NSS/NCC/Sports Certificate (if any)
Yes No

Character Certificate (if any)
Yes No

Medical Certificate
Yes No

Other Certificate If any
No Yes

10th Marksheet (.jpg, .png only) & File size must be less than 1 MB*

10th Certifiacte (.jpg, .png only) & File size must be less than 1 MB*

12th Marksheet(.jpg, .png only) & File size must be less than 1 MB

*Please keep your duly filled application form with Payment Transaction /Reference Number for further references.