OFFICIAL DETAILS
Registration Date:	Registration No. :	Center Code :

Branch*

Select BranchJalandharHoshiarpurMaqsudanKot FatuhiJalandharPhagwaragangatechLudhiana

Joining Date

PERSONAL DETAILS
Student Name*
Father's Name*
Date Of Birth*
Email*
Qualification*
Workplace/College*
Contact Address *

CONTACT DETAILS
Phone No.*		Whatsapp		Parents No.

COURSE DETAILS
Course Type*	Select Course Type Civil Mechanical Computer Application IT Graphic Designing Digital Marketing
Name of Course*	Select Course Name
Software Covered*
Duration Months*	--Select Duration Month-- 6 Weeks 1 Month 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 1 Year
Duration Time*	--Select Duration Hours-- 1 Hours 2 Hours 3 Hours 4 Hours 5 Hours 6 Hours 120 Hours 360 Hours
Course Fee*	Rs (like 10000)