Application Form

*Note : After filling the form and application fees please send your confirmation details in [email protected] or whatsapp in 7720094513
STUDENT DETAILS

First Name *
Middle Name *
Last Name *
Date of Birth *
Email Address *
Mobile Number *
Alt. Mobile Number
Course Name *
Marks Scored In 10th (% only)*
Marks Scored In 12th (% only)*
FATHER DETAILS / GUARDIAN DETAILS

Father Name
Father Mobile Number
Father Occupation
Annual Income Upto *
Upto 3 LacUpto 5 LacUpto 10 LacMore Than 10 Lac
YOUR ADDRESS

Permanent Address:

Current Address:

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