1 Name of the candidate

2 Surname
3 Father Name
4 Mother Name
5 DOB
6 GENDER
CASTE(BC-A,BC-B,BC-C,
BC-D,BC-E,OC,SC,ST)
7 Address for Communication

7A District
7B MANDAL
7C Pincode
8 Email
9 MOBILE
10 Reservation Category
11 Category(General/Minority)
Are you a Orphan
(a child whose parents are dead)
12 (Yes / No)
Are you CAP
(Childern of Armed Personnel)
13 (Yes / No)
Whether the Anual Income
of Parent is below Rs.60,000(for
14 2015-2016)
Are you a
Physically Handicapped(PH)
15 Person
Govt./Govt Aided/
Govt Recognized
16 (Rural/Urban) (Medium of study)
Medium in which candidate
desires to appear for the
17 TesT(TELUGU/ENGLISH)

Examination Center/District
at which Candidate desires to
18 appear for the Test *

Examination Center/Division at
which Candidate desires to
19 appear for the Test
(ANANTAPURAMU/DHARAMAVARA
MU/KADIRI/KALYANDURG/PENUKO
NDA)

ANANTAPURAMU

1 Name of the candidate

2 Surname
3 Father Name
4 Mother Name
5 DOB
6 GENDER
CASTE(BC-A,BC-B,BC-C,
BC-D,BC-E,OC,SC,ST)
7 Address for Communication
7A District
7B MANDAL
7C Pincode
8 Email
9 MOBILE
10 Reservation Category
11 Category(General/Minority)
Are you a Orphan
(a child whose parents are dead)
12 (Yes / No)
Are you CAP
(Childern of Armed Personnel)
13 (Yes / No)
Whether the Anual Income
of Parent is below Rs.60,000(for
14 2015-2016)
Are you a
Physically Handicapped(PH)
15 Person
Govt./Govt Aided/
Govt Recognized
16 (Rural/Urban) (Medium of study)
Medium in which candidate
desires to appear for the
17 TesT(TELUGU/ENGLISH)

Examination Center/District
ANANTAPURAMU/DHARAMAVARA
MU/KADIRI/KALYANDURG/PENUK
ONDA
at which Candidate desires to
18 appear for the Test *