CIPS - Admission Form 2026-27

Select Course Option

Personal Information

Candidate's Name (As per HSSLC Certificate)

Father's Name

Mother's Name

Date of Birth

Gender

Male Female

Category

GENERAL OBC/MOBC SC STP STH

Economically Weaker Section (EWS)

Yes No

Physically Handicapped (Divyang)?

Yes No

Degree of Disability (%)

Nationality

Indian Others

Religion

Hinduism Islam Christianity Sikhism Buddhism Others

Physical Identification Mark 1

Physical Identification Mark 2

Are you a Permanent Resident of Assam?

Yes No

Current Address

Address Lines

City

Pin Code

District

State

Permanent Address Same As Current

Address Lines

City

Pin Code

District

State

Contact Details

Mobile Number

Email Address

HSLC Board & Medium

Board Name

CBSE SEBA OTHER

Board Medium

ASSAMESE ENGLISH OTHER

HSSLC Examination Details

Date of Passing HSSLC (or Equivalent)

Educational Institution Name (HSSLC)

Board/Council/University Name

Marks Secured (HSSLC or Equivalent)

#	Subject Name	Full Marks	Marks Obtained
1
2
3
4
5
Total Percentage (%) :

Upload Documents

Tap or click the boxes below to upload images or PDFs.

Passport Photo

Signature

Qualification Cert.

Aadhaar Card

How did you know about CIPS?

Friends/Family Newspaper Internet Radio/TV Facebook Instagram Youtube Twitter

Declaration by the Candidate

I declare that the above entries in the Application Form have been filled up by me and the entries made are correct as per my documents and to the best of my knowledge and belief. I agree that if any statement is proved to be false then the Authority shall have the right to take legal action against me for submitting false information. I further declare that there is no allegation of misconduct against me and I have never been convicted for any offence involving moral turpitude.

PARAMEDICAL ADMISSION : 2026-27