Admission For:

Academic Year:

Batch:

Subject:

Name (in full):

Date of Birth:

Aadhar card:

College Name:

Collage
Timing for XI / XII:

Residential Address:

Pincode:

Residential Phone No:

Father's /Guardian's
Name:

Father's /Guardian's
Occupation:

Office Phone:

Mobile No:

E-mail Id:

Mentioned Name of Coaching Class (if any) attended by you last year:

Details of last Exam Passed- X / XI:

Year:

Aggregate%:

Maths%:

My Ambition in Life is to become :

And/Or

Mention the namaes of the three students of current academic year who wish to take Admission.

Contact Details:

1)Name:

Mobile No.:

2)Name:

Mobile No.:

3)Name:

Mobile No.:

How did you come to know about this institute:

*(FEES ONCE PAID WILL NOT BE REFUNDED OR ADJUSTED OR TRANSFERED TO ANOTHER STUDENT UNDER ANY CIRCUMSTANCES)