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Name *
Father's Name *
Correspondence Address
Landline Number
(For Outstation, please don’t prefix “0”)
Mobile Number *
(Enter Correct and Valid Email)
Email Address *
(Enter Correct and Valid Email)
Gender
Batch allowed
Course
Marks in 10th (%) *
Marks in 12th (%) *
% in Graduation (in Case of M.E. / M. Tech / MCA / M.Sc. ONLY)
% in B. E. / BCA / B.Sc. ONLY
% in Post Graduation (in Case of M.E. / M. Tech / MCA / M.Sc. ONLY)
College
University
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