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1. Student Name With Initials :
2. Enquiry for :
--Select Type--
I PUC
II PUC
3. Name Of the Parent :
4. Contact Number (Whatsapp Number) :
5. Alternate Number :
6. Address:
7. District :
8. State :
9. Name of the School Studying / Studied :
10. Class 10th Expected Percentage :
11. Class 10th Board of Examination :
--Select Type--
State
CBSE
ICSE
Other
12. Perference of combination:
--Select Type--
PCMB
PCMC
13. Compitative Course :
--Select Type--
NEET + CET
JEE + CET
14. Wish to be ? :
--Select Type--
Day Scholar
Hosteler
15. Came to Know about college through :
--Select Type--
Student / Parent
Faculty
Friends / Relatives
Promotinal Team
Ads / Pamphlets / Online
Other
16. Any Queries :