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Enrolment Request Form
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* Indicates required question
Student Name
*
( ਵਿਦਿਆਰਥੀ ਦਾ ਨਾਂ )
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Gender
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Male
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Date of Birth
( ਜਨਮ ਦਿਨ ਦੀ ਮਿਤੀ )
MM
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DD
/
YYYY
Occupation
( ਕਾਰੋਬਾਰ )
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Address
( ਘਰ ਦਾ ਪਤਾ )
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Phone Number
*
( ਫੋਨ ਨੰਬਰ )
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Email
*
( ਈ - ਮੇਲ )
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Please advise of illness or medical condition (if any)
( ਕਿਰਪਾ ਕਰਕੇ ਸਾਨੂੰ ਆਪਣੀ ਬਿਮਾਰੀ ਜਾਂ ਡਾਕਟਰੀ ਸਥਿਤੀ ਬਾਰੇ ਸੂਚਿਤ ਕਰੋ (ਜੇ ਕੋਈ ਹੈ) )
Your answer
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