Application Form

👤 Personal & Contact Information * Required fields

1Course Opted For

2Salutation

3First Name

4Middle Name

If no middle name, enter a dot ( . )

5Last Name

6Email Address

7Candidate Mobile

Exactly 10 digits

8WhatsApp Number

9Parent / Guardian Mobile

10Alternate Mobile

11Communication Address

12City

13State

14PIN Code

15Date of Birth

16Age (Years)

17Gender

Male Female Transgender

18Nationality

19Category

20Religion

21Caste

22Marital Status

Single Married Divorced Widowed

23Aadhaar Number

Exactly 12 digits

24Family Annual Income (₹)

Parent/Guardian income for 2023-24

25How did you hear about us?

26. Permanent Address same as Communication Address

26Permanent Address

27Do you need Hostel Accommodation?

Yes No

27aWill you accept admission without hostel?

Yes No

🌐 Languages Known (Check all that apply)

Language (specify)	Read	Speak	Write

28Co-curricular activities participated in school/college

29Mention your Hobbies

30Are you gainfully employed at present?

Yes No

31Did you apply for admission to this course earlier?

Yes No

32Has any relative studied social work at CSRD?

Yes No

🎓 Educational Qualifications

Examination	Board / University	Subject / Stream	Year	Total Marks	Marks Obtained	% (Auto)	Result / Grade
2710th (SSC) *
2812th (HSC) *
29Graduation *
30Post-Grad (if any)

* Required fields · Enter Total Marks & Marks Obtained — percentage is calculated automatically

31Degree Completed / Appearing

32Specialization / Major

33Work / Volunteer Experience

📎 Document Uploads JPG, PNG, PDF · Max 2 MB each

34Identity Proof Type *

Select ID type above, then upload the document below

📷

33Passport Size Photograph *

image/* · Max 1 MB

✓ Selected

🪪

34Identity Proof (as selected above) *

.pdf,image/* · Max 2 MB

✓ Selected

📄

3510th (SSC) Marksheet

.pdf,image/* · Max 2 MB

✓ Selected

📄

36HSC Marksheet *

.pdf,image/* · Max 2 MB

✓ Selected

🎓

37Graduation Marksheet or Second-Year Graduation Marksheet *

.pdf,image/* · Max 2 MB

✓ Selected

📋

38Documentary Proof of Category (as per Col. No. 19) *

.pdf,image/* · Max 2 MB

✓ Selected

✍️

39Signature of Student *

image/* · Max 500 KB

✓ Selected

Declaration
I hereby declare that all information furnished in this application is true, complete and correct to the best of my knowledge and belief. I understand that any misrepresentation or suppression of facts may lead to cancellation of my admission without prior notice. I have read and agree to the above declaration. *

⚠ You must accept the declaration to proceed.

💳 Review & Payment

👤 Personal Details

🎓 Academic Details

Application Fee

₹—

Non-refundable | Select course on Step 1 to see fee

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Application Submitted Successfully!

Your payment has been confirmed. Keep your application number for future correspondence.

CSRD-2026-XXXXX

A confirmation email has been sent to your registered email address.

📄 Download Application Form (PDF)

BPHES-CSRD-ISWR, Ahilyanagar

BPHES-CSRD-ISWR, Ahilyanagar

👤 Personal Details

🎓 Academic Details

Application Submitted Successfully!