SGRR Student Uttarakaand Board Student Other Student Continue Continue Uttarakaand Board Student Continue Continue Continue Super50 Application Form Medical Application For Course Date of Birth Dehradun Haridwar Kotdwar Srinagar (Garhwal) Muzaffarnagar Exam Centre First Choice Dehradun Haridwar Kotdwar Srinagar (Garhwal) Muzaffarnagar Select Exam Centre Second Choice The Form is to filled in Block Letters: Name In Full Mother's Name Father's / Guardians Name Parents/Guardian's Occupation Mobile Permanent Address (Do not write father's / guardian's name here) Male Female Select Gender General SC ST OBC Others Select Category Physically Handicapped Defense Ward Survivor Of Freedom Fighter None Select Sub Category Email City Pin Code Name of the School (from where appeared for class XII): Name Of School With Address Percentage Of Marks Obtained in Class X : Maths Science Aggregate Percentage Of Marks Obtained in Class XII : Passed Appearing 12th Exam Physics Chemistry Biology Aggregate Upload documents: (Note: upload photo size should be less than 200kb.) Student Signature Parent's Signature Student Photo