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Application Form 2021-22

REGISTRATION APPLICATION FORM FOR COURSE
1. Course Details*Mandatory fields
Branch
*
2. Applicant's Personal Details
Canditate's Name * (Full name as per the highest / latest qualification certificate or legal certificate)
Father's /Guardian Name * (Full Name As Per Educational/Legal Certificate)
Mother's Name * (Full Name As Per Educational/Legal Certificate)
Gender *
Date of Birth * (dd-Mon-yyyy)
Category *
Religion *
Nationality *
Aadhar Card No.*
3. Contact Details
Mobile Number *
Email Address *
Father's Contact No.
4. Address Details (4A is Correspondence Address) , (4B is Permanent Address)
4A - Address for Correspondence *
4A - Pincode * :
4B - Permanent Address * (Copy Address)
4B - State *
4B - District *
4B - Pincode *
4. Educational / Qualification Details
S. No. Name of Exam Board/University Passing Year Institution Subject Marks Percentage
1. High School (SSLC) * 
%
2. Intermediate *
%
3. Others
%
Parent's Details
Parent's Educational Qualification *
Parent's Employment Details
Name of the Organization *
Designation *
Organization Contact No. *
Address of the Organization *
5. Upload Photo & Signature
Upload Photo*
Upload Signature*
( JPG,JPEG,PNG image with size upto 20 KB )
Fee Rs.5000/-