Registration Form

Interested to Join*
Course fee*
I want to deposit* Full payment      Registration Fee only
Full Name*
School's Name*

(Class 12th)

Father's Name*
Father's Occupation*
Date Of Birth*

(Date of Birth as recorded in the
Matriculation/Secondary Examination Certificate)

Mailing Address*
Telephone No. with STD code
Personal Mobile No*
Parents Mobile No*
E-mail ID*
Marital Status*

Educational Qualification (fill as per requirement)*

Exam Passed Board / University Year of Passing Subject Total %age English Marks
10th 10th 12th
10 + 2 Pass 12th (PCM %)
10 + 2 Appearing Expected in 12th (PCM %)
B.Sc. College's Name
Note: Candidate those are waiting for their results can write their expecting percentage.
I here by declare that all the information as given above are correct to the best of my knowledge and belief. I understand and will follow all the decision of the institution with regard to conduct good discipline and best training. I further declare that in the event of any information being found false or incorrect. My candidature / course is liable to be rejected / terminated without notice.
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