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Student Enquiry Form

Enquiry No : .……………….. Date : …………………

Academic Year 201__ – 201__


Course: B.Sc./Diploma/MBA/B.Com/BBA/Craft Course …………...
Name of the student………………………………………………………………………… (CAPITAL LETTERS)
1. Date of Birth………………………………………………….………………………..…………...
2. Father’s Name…………………………………………….……………………………..…………
Occupation………………………………………………………..……………………….………..
3. Mother’s Name………………………………………………………………………….………….
Occupation………………………………………………………..………………………………...
Permanent Address…………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………..
Pin Code…………………………..………
Student Mobile No ……………………………………………………….….
Parent’s Mobile No ..……………..…………………………………………..
E-mail Address………………………………………………………………..
4. Gender : Male / Female
5. Source Of Enquiry : God Card Wall Poster Banner Just Dial Bit Notice Balloon
Wall Painting College Banner School Seminar T.V News Paper: …………………….…...
Student Reference: Name ………………………….. WEB Others …………………………….……
6. Application Sold : Yes / No
7. Academic Qualification (Class 8/10th onwards)

Examination School/College Board/University Year of % of


Passed Passing Marks

8/10th

12th

Any Other
Graduation

Name of Counselor : ………...……………


Signature : Student Signature

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