Common Application Form
for Admission to Degree Colleges (2011-12) 
Department of Higher Education, Government of Odisha
+3
* Mark indicates mandatory field
1.    Name of the Council from which you have passed the +2 exam, Year of Exam & Roll Number (as in admit card)
 
Name of the Examination Council * Year of Passing * 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 (B/C)  NCC (CAMP/COURSE) 
 
b.   NSS Camp
University Level State Level National Level International Level
c.   Rover & Ranger
Rajya Puraskar (RP) President Recognition (PR)
d.   Sports & Games
Inter State National International
  • MIL Mark is not mandatory • Total Mark Secured, is the mark secured in all subjects of +2 Exam
9. Details of Mark Secured in +2 Council Examination *   
 
a.
MIL English Chemistry Mathematics Biology Total Mark Secured Maximum Mark
b. Have you passed +2 Council  Exam Compartmentally ? No Yes
  You are required to select at least ONE and at most TEN options.
Choose your 1st Option
a. District Name *
b. College Name * c. Stream *
d. Stream Preference *  Pass  Honours
e. Honours Name in order of preference
First Preference * Second Preference  Third Preference 
f. Are you interested to reside in hostel ? * Yes No 
Note:
Do not click SUBMIT button, if you want to select more options.