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PLACEMENT DRIVE - REGISTRATION FORM
Venue
Date
Personal Details
Student Name
*
Please Enter Student Name!
Father's Name
*
Please Enter Father Name!
Mother's Name
*
Please Enter Mother Name!
Date Of Birth
*
--Day--
Select a Day
--Month--
Select a Month
--Year--
Select a Year
Gender
*
--Select--
Male
Female
Select a Gender
Institution Name
*
--Select--
Select a Institution
Year of Passing
*
Select Year
Please select Year of Passing !
Current Pursuing Degree
*
Select Degree
UG
PG
Please select Current Degree !
Current Pursuing Course
*
Select Course
Please select Current Course !
Email-id
*
Please Enter Mail Id!
Enter a valid email id!
Mobile Number
*
Enter the Mobile Number !
Contact number should in numeric digits!
must be 10 numbers
Address for Communication
Address 1
*
Please Enter Your Address!
City
*
Please Enter Your City!
District
*
Please Enter Your District!
State
*
--Select--
Please select Your state!
Pin Code
*
Please Enter Your Pin Code!
Enter 6 digit pin numbers
School Educational Details
Class X
*
Group / Stream / Branch
Please Enter Group / Stream / Branch !
Year of Passing
Select Year
Please select Year of Passing !
Marks (%)
Please Enter Marks (%) !
Please Enter Only Numbers
Name of the Institution
Please Enter Name and Location of the Institution !
Class XII
Group / Stream / Branch
Please Enter Group / Stream / Branch !
Year of Passing
Select Year
Please select Year of Passing !
Marks (%)
Please Enter Marks (%) !
Please Enter Only Numbers
Name of the Institution
Please Enter Name and Location of the Institution !
College Educational Details of UG / PG
UG
Name & Location of the Institution
Please Enter Name and Location of the Institution !
Degree
Select Degree
Please select Degree !
Year of Completion
Please enter Year of Completion !
Please Enter Only Numbers
Total Marks (%) / CGPA
Please enter CGPA !
Please Enter Only Numbers
PG
Name & Location of the Institution
Degree
Select Degree
Year of Completion
Please Enter Only Numbers
Total Marks (%) / CGPA
Please Enter Only Numbers
Others
Name & Location of the Institution
Degree
Year of Completion
Please Enter Only Numbers
Total Marks (%) / CGPA
Please Enter Only Numbers
Declaration
I declare that all the above details are true to the best of my knowledge. I intend to attend the scheduled training classes and would participate in all the events conducted as part of the Training program.
Please check the declaration to continue