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For Admissions Contact: 9840226899 ,9840866558
For Admissions Contact: 9840226899 ,9840866558

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ONLINE REGISTRATION FORM 2022

Your Name : [your-name]
Father's Name : [fathers-name]
12th / Diploma Reg. No : [reg-no]
D.O.B : [dob]
Community : [community]
Course Selected [course]

Marks obtained in 12th Standard

Mathematics : [mark-maths]
Physics : [mark-physics]
Chemistry : [mark-chemistry]

Marks obtained in Diploma

Percentage of Marks obtained in Diploma : [diploma-percent]
Your Email : [email]
Mobile 1 : [mobile1]
Mobile 2 : [mobile2]
Address for Communication : [address-comm]

    Batch* (Passed out)

    Department *

    Field of Nomination *

    Name*

    Email*

    Age*

    Company Name

    Present Designation

    Experience*

    Mobile

    Evidence / Documents supporting nomination (Max 2MB/ File or Document))*

    Optional

    Optional

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