Learning Institute

Registration Form





Upload Photo
 
Signature
 
NAME OF THE CANDIDATE IN CAPITAL LETTERS *
FATHER'S NAME IN CAPITAL LETTERS *
MOTHER'S NAME IN CAPITAL LETTERS *
Email *
COMPLETE ADDRESS *
 
PIN CODE *
DATE OF BIRTH * YY MM DD
MOBILE NO
GENDER * Male Female
CAST * General OBC Sc/St
Are you Handicaped * Yes No
CLASS * 10 12
MEDIUM * Hindi English
PREVIOUS QUALIFICATION
NOIS SUBJECT(MINIMUM 1 SUBJECT MAXIMUM 8 SUBJECT)
IF 12TH ADMISSION THEN FILL 10TH INFORMATION YEAR OF PASSING ROLL NO

Name of Board 

10TH BOARD NAME
12TH BOARD NAME
TOC(Transfer of credit) Roll No(TOC) Year
TOC OF BOARD
TOC SUBJECT