Dr.Lankapalli Bullayya Junior College

Student Name(As per SSC/CBSE/ICSE)

Gender:
Male Female

Father's Name

Date of Birth

Place of Birth

Temporary Address

Permanent Address

Father's Mobile

Father's Occupation & Education

Mother's Mobile Number

Mother's Occupation & Education

Reservation Category

Family Members Educational Qualifications:

Brother

Sister

Name of the Institution (Last studied with address)

Details of Qualifying Examination:

Year of Passing

Hall Ticket Number:

Aadhar Number

Group in to which admission is sought :

Select Second Language:

Where did you reside :
At home with parents With Guardian At hostel

Distance from college (in km): :

Will you interested to join:
JEE MAINS NEET EAPCET