JSS Institute of Speech and Hearing, Dharwad

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Documents Required

Scanned passport size photo
Scanned copies of 10th and II PUC/12th Marks card
NEFT/IMPS payment details towards application fee of Rs.500/- (UTR number, Bank name, Deposit date).

Upload Your Passport Size Photo *
Please upload file less than 2MB

Personal Information (All fields are mandatory*)

Gender

Male

Female

Transgender

Nationality

Indian

Others

Please attach the scanned documents in the given order

Marks Cards of I PUC/II PUC *
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SSLC Marks Card *
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Caste/Reservation Certificate
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Payment Details (All fields are mandatory*)

UTR Number

Bank Name

Date of Payment

Bank Details

Account Holder Name – JSS Institute of Speech and Hearing, Dharwad
Account Number – 1922000100026401
IFSC Code – KARB0000192
Bank Name – Karnataka Bank ltd.
Branch – KUD circle branch, Dharwad

Declaration By The Applicant (All fields are mandatory)*

I hereby solemnly and sincerely affirm that the statement made and information furnished in my application form and also in the enclosures submitted by me are true, should it, however be found that any information furnished there in is untrue in material particulars, I realize that I am liable to criminal prosecution and the seat given to me shall be Liable to be forfeited.

Applicants Declaration

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