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REGISTRATION FORM


ASC Code
Course Name
Course Duration
State Code
Course Code
Date Of Submission
1. Full Name of the Applicant ( As Per Certificate ) 
2. Father’s Name ( As Per Certificate ) 
3. Mother’s Name ( As Per Certificate )  
4. Present Address
5. Permanent Address
6. City/District
7. State
8. Pin Code
9. M. No.
10. Email ID  
11. Category
GC
OBC
SC
ST
Handicapped
12. Date of Birth 
13. Sex
Male
Female
14. Religion
15. Detail of Educational Qualification
Particulars Year of Passing % of Marks Board/ University School/ College
JHS/ 10th
Intermediate
Degree
Others
DECLARATION BY THE APPLICANT

I hereby declare that i read all the rules and regulations of the institute and i am committed to follow all the rules with best of my efforts. If found any violation then the institute authority has the rights to terminate my registration. In case of termination the institut e will not responsible for any fee return or any kind of claim. I also declare of my knowledge.