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Applicant Name

Photo Upload

Email

Father's Name

Sex

Male

Female

Date of Birth

Course Name

Occupation

If Student give following details :

College Name

Course Name

Year

If Professional then gives following details :

Name of Organization

Designation

Experience

Working Platform

Highest Qualification

From where you get the information about center :

Senior Student

Classmate

Shine Board

News paper

Professional

Placement Agencies

I.T. Company

Others

Address

Contact No

Payment Mode

Full

Installment

Course Fees

Fees to be Paid

Fees Payment Date

DD Number

DD Bank Name

DD Date