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Admission Form

Sr.no………. Reg.No……………………..

1. Name of the Student…………………………………………………………..


Student Photo
2. Course ………………………………………Timing ………..…………………..
3. Father’s Name ……………………………………………………………………
4. Mother’s Name …………………………………………………………………..
5. Date of Birth ………………………………………………………………………
6. Address ……………………………………………………………………………..
…………………………………………………………………………………………………………………………………….
State…………………………………City…………………………………Pin code……………………………………
7. Phone Number (1)……………………………………………….(2)
…………………………………………
8. Qualification (10th)………………..(12th)……………………(Graduation)
…………………………..
9. Category (General) …………………..(SC/ST)………………………..(OBC)
………………………..
10. Other
Information………………………………………………………………………………………………
Here I ……………………… Declare All the information are given above are truly
and correct in my knowledge.

Signature of the Student

Duration of Course : …………………………………………………………………………………….…………..


Date of Joining …………………………………………….Total course Amount……………..……………
First Fees Date…………………………Amount ……………..…. Rec.No…………………Signature…………………..…….…
Second Fees Date……………………Amount ……………..…. Rec.No…………………Signature…………………..…….…
Third Fees Date……………………….Amount ……………..…. Rec.No…………………Signature…………………..…….…
Fourth Fees Date…………………….Amount ……………..…. Rec.No…………………Signature…………………..…….…
Fifth Fees Date………………………..Amount ……………..…. Rec.No…………………Signature…………………..…….…
Sixth Fees Date……………………….Amount ……………..…. Rec.No…………………Signature…………………..…….…
Seventh Fees Date………………….Amount ……………..…. Rec.No…………………Signature…………………..…….…
Certificate Fees Date………………Amount …………….…. Rec.No…………………Signature…………………..…….…
Signature of Student for Certificate Receiving………………………………………………………………………………………

Sr.No Jan Feb Mar Apr May June other


1 Sunday
2 Sunday
3 Sunday
4 Sunday
5
6 Sunday
7 Sunday Sunday
8
9 Sunday
10 Sunday
11 Sunday
12
13 Sunday
14 Sunday Sunday
15
16 Sunday
17 Sunday
18 Sunday
19
20 Sunday
21 Sunday Sunday
22
23 Sunday
24 Sunday
25 Sunday
26 Rep. Day
27 Sunday
28 Sunday Sunday
29
30 Sunday
31 Sunday

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