All fields marked by (*) are compulsory.
COURSE INFORMATION
Reg. No. / Student ID *
Center *
Course Academic Year
PERSONAL INFORMATION
Student Name *
Date of Birth * [YYYY-MM-DD] Gender
Category
Father Name
Mother Name
ADDRESS INFORMATION
Address
City Pin
Parent Mobile *
Student Mobile
Email
ACADEMIC INFORMATION
Class Medium Board
School Name
FIRST INSTALLMENT DETAIL
Date * [YYYY-MM-DD] Receipt No. Payment Mode Amount *
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