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PERSONAL & CONTACT DETAILS

Candidate Name :

Father's Name :

Name of Course

COURSE FEE ₹ 6500 ($100)

Date of Birth : (DD/MM/YYYY)

Email Address :

Password :

Mobile No :

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Category :
General OBC SC ST

Gender :
Male Female

Physicallay Handicapped :
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Whether From Minority:
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EDUCATION QUALIFICATION

Exam Passed or appearing in :

Name of Board/ University :

Year of Passing :

Subject Studied :

INDUSTRY EXPERIENCE

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Designation :

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From Date :

To Date :

ADDRESS:

PERMANENT

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Check this if Permanent address and Communication address are the same.

COMMUNICATION

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