Common Application Form
for Admission to Junior Colleges (2012-13)
Department of Higher Education, Government of Odisha
+2
* Mark indicates mandatory field
1.    Name of the Board from which you have passed the 10th exam, Year of Exam & Roll Number (as in admit card)
 
Name of the Examination Board * Year of Passing * Exam Type   Roll Number *
 
2. Applicant's Name *
3. Father's Name *
4. Mother's Name *
5. Personal Details
Blood Group Gender * Religion * Date of Birth *
Click here to upload your photo

6. Address for Correspondence
 
a. State * b. District * c. Block / ULB *
d. House No., Street/Village, Post Office, Police Station Name * e. PIN Code 
f. Telephone No. -
Area Code  -  Phone No
g. Mobile No. h. e-Mail
7. Reservation Details
 
a. Schedule Caste (SC) Others
b. Physically/Orthopedically Handicapped (PH/OH)
c. Ex-Service Man (ESM) Children of Martyrs (CoM) Serving Defence Personnel (SDP) None
d. Are you an Outside State Applicant (OSA)? No Yes
e. Are you an Oriya Living in Neighbouring State (OLNS) ? No Yes
8. Weightage Details
 
a. NCC
NCC (A) NCC (C)
 
b. Scout & Guide
Rajya Puraskar (RP) President Recognition (PR)
 
c. Sports
State National International
9. Details of Mark/Grade Secured in 10th Board Examination *
Note: the below field will show grade point, if you select CBSE & 2011 as year of passing
 
a. Mark/Grade secured in each subject in 10th Board Examination 
English Mathematics Science Social Science Total Mark Secured Maximum Mark
b. Have you passed 10th Board Exam Compartmentally ? No Yes
You are required to select at least ONE and at most SIX options .
 
Enter here for 1st  Option
 
a. College Type * Self Financing Others      
b. District Name *
c. College Name * d. Stream *
e. Compulsory (MIL) *
f. Elective Subject
First Elective * Second Elective * Third Elective *
g. 4th Elective in order of preference
First Choice * Second Choice Third Choice
h. Are you interested to reside in hostel? * Yes No   
 
Note:
Do not click APPLY button, if you want to select more options.