Course Online Registration Form


* Specifies fields are mandatory


Student Personal Details

Select Course *

Candidate First Name *

Candidate Last Name

Gender *

Whether belonging to General/SC/ST/OBC *

Date of Birth *

Nationality *

Religon *

Aadhar Card No


Address For Communication

Address *

Pin Code

City *

State *

Country *

Permanent Residential Address


Same as above    

Address *

Student's Contact Details

Mobile No.*

Alternate Mobile No.

Email (If any)

Guardian Personal Details - Guardian 1

Name of Father *

Father / Guardian Contact No. *

Name of Mother *

Mother Contact No. *

High School or Equivalent Details

Year of Passing *

Roll No. *

Board / University *

Marks Obtained *

Percentage (%) *

Div / Grade *

Subject *

Intermediate or Equivalent Details

Year of Passing *

Roll No. *

Board / University *

Marks Obtained *

Percentage (%) *

Div / Grade *

Subject *

Graduation Details

Year of Passing

Roll No.

Board / University

Marks Obtained

Percentage (%)

Div / Grade

Subject

Other Exam Details

Year of Passing

Roll No.

Board / University

Marks Obtained

Percentage (%)

Div / Grade

Subject

Permanent Residential Address


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