Admission Form

Admission for Academic Year
2022-242023-25

Courses Offered
XIXIINEET PCBJEE (Mains) PCMJEE (Adv) PCM

Date of Admission

Full Name (Surname, Name)

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Date of Birth

Gender
MaleFemale

Category
---GENOBCSTSCOthers

Residential Address

PIN

Tel

Student's Mobile

Student's email

Name of College

Father's Information

1. Father's Name
   
2. Father's Mobile
   
3. Father's Email
   
4. Father's Occupation
   

Mother's Information

1. Mother's Name
   
2. Mother's Mobile
   
3. Mother's email
   
4. Mother's Occupation
   

Have you ever appeared for any competitive exams?
NTSEHOMI BHABHAOLYMPIADSNEMC

Name of school in STD. X

Marks Secured in STD. X
Mathematics

Science

Grand Total

Aggregate percentage

Attach Photocopy of your Mark List

Student's Signature

Parent's Signature