General Purpose (GP) Rating

Online Application Registration Form
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Fields marked with * are mandatory
Personal Details
  Application No.
  Name of the Candidate*
  Father's Name*
  Date of Birth*
  Marital Status*
  Indos No.
  Passport No.
  CDC No.
Address for Communication
  Flat/Door/Name of Building*
  Road/St./Lane/P.O.*
  Area / Locality*
  Town/City/District*
  Pin-Code*
  State/Union Territory*
  Phone - Home
  Mobile*
(Please give a valid Number)
  Email*
(Please give a valid Email ID)
PARTICULARS OF 10th EXAMINATION
Mark Obtained Maximum Mark
  English*
  Maths*
  Science*
  Total*
  Class
  Year
  Registration Number
  Name Of The Board
PARTICULARS OF 12th EXAMINATION
Mark Obtained Maximum Mark
  Total
  Class
  Year
  Registration Number
  Name Of The Board
PARTICULARS OF DIPLOMA EXAMINATION
Mark Obtained Maximum Mark
  Total
  Class
  Year
  Registration Number
PARTICULARS OF DEGREE EXAMINATION
Mark Obtained Maximum Mark
  Total
  Class
  Year
  Registration Number
  Applying through*

  Counselor's Name*
All correspondence / updates will be sent to this EMail ID / Mobile No.
  Are you aware of our fee structure?*

   
Bank Details
Name of beneficiary- R.L. Institute of Nautical Sciences
Beneficiary's Bank Name- City Union Bank
Address- 82A, Tamil Sangam Road, Madurai - 625 001
Account No. - 027109000119084
Account Type. - Current A/c
Branch Madurai Main
IFSC Code CIUB0000027
  Mode of Payment



  UTR No
  Date of remittance (dd/mm/yyyy)
  Name of the Remitting Bank
  Branch Name & Place
   
RLINS