State Institute of Hotel Management, Balangir

* Indicate a Mandatory Field

Course applied for *

Name of the Applicant *

Mother's Name*

Father's Name *

Aadhaar No. of Applicant *

Email Id*

Telephone/ Mobile No.*

Date of Birth *(As Given in class 10th Certificate)

Age as on 1st July *

Gender*

Male Female Other

Marital Status *

Married Unmarried

Nationality *

Religion *

Category *

Mother Tongue

Physically Handicapped *

YES NO

Percentage

Physically Handicapped Certificate

Hostel Required *

YES NO

Occupation of Father/Guardian *

Guardian's Name (If father is not alive)

Annual Income of Guardian

Identity mark on body

NOTE BY :- APPLICATION FORM WITH INCOMPLETE INFORMATION/FALSE ENTRY ARE LIABLE TO BE REJECTED AND ADMISSION WILL BE FORFEITED