1. Please Select Proper Document with size less than 5 MB!!!
2. Documents(images and pdf) are only acceptable.

Preference

Preferred Year: * Preferred Intake: *
Level * Interested Course *
Date: * Inquiry No: *
Form No: Course Group: *
Enrollment Type: * Information Source:

Student Info

First Name: * Middle Name:
Last Name: * Date Of Birth (B.S)B
Date Of Birth (A.D) Mobile: *
Gender: *      
Religion: Nationality:
Country: District:
Municipality/VDC: Ward No:
Permanent Address Temporary Address:
Home Phone No:
Email: *
Photo: ...

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Mother Details

Full Name:* Occupation:
Mobile No: Other Phone No:
Email Current Address

Father Details

Full Name:* Occupation:
Mobile No: Other Phone No:
Email Current Address

Local Guardian Details

Full Name:* Occupation:
Contact No:* Email
Current Address*
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Referred By

Name(Referred by): Contact No.(Referred by):
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