Registration Form                 [PAY ATTENTION]



Interested to Join*                  :
Courses*                  :
Fees: :
Course fee Reg Fee:
 I want to deposit


(Please write the course name in which you are interested)

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]
Category*                               :  
Mailing Address*                     : 
District/City*                          : 
State/UT*                               : 
Contact Details 
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
B.Tech. College's Name
Note : Candidate those are waiting for their results can write 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.

Upload Photograph *                                   :    
(Max Size 50 KB, Only jpg, png allowed)
Upload Marksheet *                                     :  
(Max Size 50 KB, Only jpg, png allowed)
Type Security Code *                                   : 
Date    :            (*) - Star marked fields are essentially to be filled by the candidate.