STUDENT REGISTRATION FORM
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1. APPLICANT'S FULL NAME:
(max 30 characters a-z and A-Z)
2. FATHER'S NAME:
(max 30 characters a-z and A-Z)
3. MOTHER'S NAME:
(max 30 characters a-z and A-Z)
4. DATE OF BIRTH:
Day:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year:
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
5. CATEGORY:
Select one:
General
OBC
SC
ST
6. EMAIL ID:
7. MOBILE NUMBER:
(10 digit number)
8. GENDER:
Select one:
Male
Female
9. ADDRESS:
10. CITY:
(max 30 characters a-z and A-Z)
11. PIN CODE:
(6 digit number)
12. STATE:
(max 30 characters a-z and A-Z)
13. QUALIFICATION:
(max 30 characters a-z and A-Z)
14. COURSES
APPLIED FOR:
select..
TALLY(GST)
DTP
CCC (NIELIT)
CCC+ (NIELIT)
'O' LEVEL
PYTHON
JAVA CORE
C++ PROGRAMMING
'C' PROGRAMMING
JAVA SCRIPT
PHP
MS-EXCEL
MS-WORD
MS-POWERPOINT
HTML CSS
CORELDRAW
PHOTOSHOP
15. PLEASE SUBMIT FEES:
(Submit your fee at institute cash counter)
16. YOUR REGISTRATION NUMBER IS:
(Note: Admission will be confirmed after submit course fee)
17. Upload Photo
18. Upload Signature
19. Upload Left Hand Thumb Impression