Student Registration Form


STUDENT REGISTRATION FORM

Student Name *
(max 30 characters a-z and A-Z)
Date
(fill today’s date)
GENDER Male
Female
Cast GN
UR
OBC
ST
SC
DATE OF BIRTH

Application for Bus Fee Yes
No
Father’s Name
(max 30 characters a-z and A-Z)
Father’s Number
(10 digit number)
Mother’s Name
(max 30 characters a-z and A-Z)
Student Mobile
(10 digit number)
Course Name

Engineering Branch Name

Polytechnic Branch Name

Address
CITY
(max 30 characters a-z and A-Z)
PIN CODE
(6 digit number)
STATE
(max 30 characters a-z and A-Z)
COUNTRY
EMAIL ID
QUALIFICATION
Sl.No. Examination Board Percentage Year of Passing
1 Class X
2 Class XII
(10 char max) (upto 2 decimal)
Remark