Prayag Citizen Law College

1 Personal Information

Name Of Applicant *

Category *

Applicant Aadhaar Number *

Father's Name *

Mother’s Name *

Husband's Name (For married female candidates only)

Date of Birth (As in Highschool Certificate) *

Email

Gender *

Male Female Transgender

Marital Status *

Married Unmarried

Nationality

Religion

ABCD Id (Academic Bank Of Credits)

2 Permanent Address

Address *

District *

Post Office *

State *

Pin Code *

Mobile No. Link With Aadhaar *

Alternate Mobile No.

3 Local Address

Same as Permanent Address

Address

District

State

Post Office

Pin Code

4 Course & Other Information

Level Of Course Applied *

Fees

Admission Reference *

Admission Under

General Category Minority Category

Name of institution Last Attended

Year of Leaving the institution last attended

Year of Passing qualifying Exam

Result of Qualifying Exam

Declared Awaited

Whether enclosed T.C./C.C. in Original

Transfer Certificate Character Certificate

5 Educational Qualification

Examination	Regular/Private	Board/University	Name of Institute / College	Roll No.	Subjects Taken	Marks Obtained	Max. Marks	%	Passing Year
High School*
Intermediate*
Graduation
Others

6 Upload Documents

Student's Passport Size Photo

Student's Signature

Marksheet Highschool

Marksheet Intermediate

Caste

TC

Birth Certificate

Declaration by the Candidate

I hereby declare that all the information given by me in this application form is true & correct to the best of my knowledge & belief.