Student Registration Form: Declaration
Student Registration Form: Declaration
APPLICATION NO.
Full Name (Full Expanded Name in Block Leers to be Menoned as Appearing in Cercate: Inials are not Permied)
FIRST NAME
MIDDLE NAME
LAST NAME
FATHERS NAME
GENDER MALE FEMALE
DATE OFBIRTH D D M M Y Y Y Y
ADDRESS
COUNTRY
STATE
PIN CODE/ZIP
TELEPHONE
EMAIL ID
(NOT FOR CANDIDATES OF US)
(NOT FOR CANDIDATES OF US)
(NOT FOR CANDIDATES OF US)
I hereby declare that the information and record(s) submitted as indicated above is true and correct
to the best of my knowledge and belief.
DATE
PLACE
SIGNATURE OF CANDIDATE
DECLARATION
INSTITUTE/
COLLEGE