Diploma Admission Application

DACG Government Polytechnic Chikkamagalur · Complete all sections carefully

Step 1 of 5 — Personal Details

Personal Details

1. SATS Number *

2. Aadhar Number *

3. Full Name *

4. Date of Birth *

5. Mother's Name *

6. Father's Name *

7. Gender *

8. Religion *

9. Indian Nationality *

Yes No

Study & Quota Details

Educational & Marks Details

21. SSLC Register Number *

22. Year of Passing *

23. Qualifying Examination *

SSLC CBSE ICSE Others

24. Institution Code

25. School / College Name

26. Total Marks (Max)

Marks Obtained *

27. Science Marks *

28. Maths Marks *

Sci + Maths Total (Auto)

Category, Contact & Address

29. Special Category

30. Reserved Category Code

31. Caste Name

32. Annual Family Income (₹)

33. PIN Code *

34. Student Mobile *

35. Parent Mobile

36. Email Address

37. Residential Address *

38. Candidate Signature (Name)

39. Parent/Guardian Signature

40. Submission Date

Document Uploads

Upload clear scanned copies (JPG, PNG, PDF — max 5 MB each). Fields marked * are mandatory.

41. SSLC Marks Card *

42. Student Photo *

43. Transfer Certificate *

44. Caste Certificate *

45. Income Certificate *

46. Study Certificate *

47. Kannada Medium Certificate

48. Rural Quota Certificate

49. Special Quota Certificate

50. Aadhar Card *

Declaration

I hereby declare that all information provided is true and correct. I understand that any false information may result in cancellation of my admission.

I agree to the above declaration

Diploma Admission Application

Declaration

Application Submitted!

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