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Coaching Center Application Form
Fill out the form carefully for registration
1
Step 1
2
Step 2
Please provide your information. Our supporting team will contact you soon to provide full information.
Student's Name:
This field is required.Please enter value
Student's Father Name:
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Gender:
Male
Female
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Date of birth:
This field is required.Please enter value
Date format is invalid, please check it again
The value must be greater than or equal to -21474836487
The value must be less than or equal to 2147483647
Phone:
This field is required.Please enter value
Invalid phone number.
The value must be less than or equal to 20
Student's Email ID:
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Please enter valid email address
Last College/ university Name:
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Branch (Stream):
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Percentage or CGPA:
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Passing year:
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2014
2015
2016
2017
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Employement:
Student
Employed
Un-Employed/Job Seeker
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Courses Interested:
SCJP
SCWCD
CORE JAVA
ADV.JAVA
STRUTS
SPRING
Collections
CRT
C-Language
Unix
Bank Po's
Android
HIBERNATE
EJB
AJAX
XML
WEB SERVICES
WebLogic
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Select Joining Date:
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Date format is invalid, please check it again
The value must be greater than or equal to -21474836487
The value must be less than or equal to 2147483647
Select Timings:
Morning
Afternoon
Evening
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How did you come to Know About Coaching Center ?:
Newspaper
Teacher
Friends/ Relatives
Others
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Signature:
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