Online Application

Photo:

Name(In Devnagarik)

:

Name(In Capital)

:

Guardain Name

:

Date of Birth

:

Age

:

Sex

:

Male Female

Permanent Address

:

Phone:

Temporary Address

:

Phone:

Mobile No

:

Email:

Qualification

:

School/
College

Office Name

:

Office Tel No

Address

:

COURSES

Training

:

Morning Afternoon Evening

Computer

:

Morning Afternoon Evening

Language

:

Morning Afternoon Evening

Preparation

:

Morning Afternoon Evening

Please Specify the Media

Newspaper Board Banner Pamphlet Friends/Ex Students
Others