Preference

Preferred Year: *	2073 2074 2075 2076 2077 2078 2079 2080 2081 Academic Year must be Selected.	Preferred Intake: *	January-February August-September Other Preferred intake must be selected.
Level *	--Select-- Bachelors +2 Level must be selected.	Interested Course *	BSc . CSIT BCA BBM Science Management BBS Interested Course must be Selected.
Date: *	*	Inquiry No: *	Inquiry No cannot be Empty. *
Form No:		Course Group: *	--Select-- Course Group must be selected
Enrollment Type: *	Academic Vocational Enrollment type must be selected	Information Source:	--Select-- Exhibition Internet Newspaper Counselor/Principal Relatives/Friends Media Others

Student Info

kumat rank cannot be empty.

First Name: *	First Name must be Entered.	Middle Name:
Last Name: *	Last Name must be Entered.	Date Of Birth (B.S)B
Date Of Birth (A.D)		Mobile: *	Mobile no cannot be empty.
Citizenship No		Gender: *	Male  Female  Other
Religion:	Hinduism Christianity Buddhism Muslim Other	Nationality:	--Select-- Nepalese Indian Chinese Others
Country:	--Select-- Nepal	District:	--Select-- KATHMANDU NUWAKOT KAVREPALANCHOK SINDHUPALCHOK BHAKTAPUR LALITPUR RASUWA DHADING CHITWAN BARA RAUTAHAT MAKWANPUR PARSA DHANUSA DOLAKHA RAMECHHAP MAHOTTARI SARLAHI SINDHULI ILAM JHAPA PANCHTHAR TAPLEJUNG KHOTANG OKHALDHUNGA SAPTARI SIRAHA SOLUKHUMBU UDAYPUR BHOJPUR DHANKUTA MORANG SANKHUWASABHA SUNSARI TERHATHUM ARGHAKHANCHI GULMI PALPA KAPILVASTU NAWALPUR RUPANDEHI GORKHA KASKI LAMJUNG MANANG SYANGJA TANAHU BAGLUNG PARBAT MUSTANG MYAGDI DANG PYUTHAN ROLPA EASTERN RUKUM SALYAN DOLPA HUMLA JUMLA KALIKOT MUGU BANKE BARDIYA DAILEKH JAJARKOT SURKHET ACHHAM BAJHANG BAJURA DOTI KAILALI BAITADI DADELDHURA DARCHULA KANCHANPUR WESTERN RUKUM PARASI
Municipality/VDC:		Ward No:
Permanent Address		Temporary Address:
Home Phone No:		Passport No:
Email: *	* Email no cannot be empty.	KUUMAT/Other RANK: *
Photo:

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Mother Details

Full Name:*	Mother Name cannot be Empty.	Occupation:
Mobile No:		Other Phone No:
Email	*	Current Address

Father Details

Full Name:*	Father Name cannot be Empty.	Occupation:
Mobile No:		Other Phone No:
Email	*	Current Address

Local Guardian Details

Full Name:*	Parent Name cannot be Empty.	Occupation:
Contact No:*	Parent No. cannot be Empty.	Email	*
Current Address*	Parent Address cannot be Empty.	Relation With Student

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Referred By

Name(Referred by):

Contact No.(Referred by):

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