Preference

Preferred Year: *	2073 2074 2075 2076 2077 2078	Preferred Intake: *	January-February August-September Other
Level *	--Select-- Bachelors	Interested Course *	BSc . CSIT BCA BBM
Date: *		Inquiry No: *
Form No:		Course Group: *	--Select--
Enrollment Type: *	Academic Vocational	Information Source:	--Select-- Exhibition Internet Newspaper Counselor/Principal Relatives/Friends Media Others

Student Info

First Name: *		Middle Name:
Last Name: *		Date Of Birth (B.S)B
Date Of Birth (A.D)		Mobile: *
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 SOLUKHUMBHU UDAYAPUR 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: *		KUUMAT/Other RANK: *
Photo:

Continue Cancel

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*		Relation With Student

Continue Cancel

Referred By

Name(Referred by):

Contact No.(Referred by):

	Save   Cancel