Maharaja Agrasen International College

Admission Form

For More Enquiry
8770197498,9893242088
9981373937,8770380094

Academic details

Enquiry No :	Enquiry Date : *


Course : *	Branch :	Semester / Year

Personal details

First Name * Max. 50 characters	Middle Name	Last Name *Max. 50 characters


Gender *	Date Of Birth*	Quota*	Blood Group


Place Of Birth*	Age*	Nationalty*


Mother Tongue	Religion	Caste

Parent details

Father's First Name*	Middle Name	Last Name *


Father's Occupation Type*	Father's Annual Income	Father's Mobile No.*
Government Private Business

Mother's First Name	Middle Name	Last Name


Mother's Occupation Type
House Wife Government Private Business

Details of Qualification Acquired

High School Class X
Name of the Board/University	Subject	Year of Passing	Percentage


High School Class XII
Name of the Board/University	Subject	Year of Passing	Percentage


UG Degree
Name of the Board/University	Subject	Year of Passing	Percentage


PG Degree
Name of the Board/University	Subject	Year of Passing	Percentage


Other Degree
Name of the Board/University	Subject	Year of Passing	Percentage

Family Background

Brother Name	Profession	Office Address	Mobile No.

Sister Name	Profession	Office Address	Mobile No.

Local Guardian	Profession	Office Address	Mobile No.

Other details



Aadhar Card NO.	Are you a Domicle of Chhattisgarh	How do you come to know about MAIC?
	Yes No	News Paper Friends Other StudentOther
Extra Curricular Activities interested in:	Ambition of Life :
BandRover & RangerSport Other Activities

Contact details

Land Line No.*	Student Mobile No.*	Student Email	Parents Mob. *


Local Address *	Father's Permanent Address *

Pin Code	State *	City *	Country