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Application Form

  1. DETAILS OF FEE PAYMENT BY NEFT MODE

  2. Date of NEFT Transaction (DD/MM/YY)*
    Please Write Date of NEFT Transaction
  3. NEFT Transaction Number*
    Please Write NEFT Transaction Number
  4. Bank Name*
    Please Write Bank Name
  5. Branch Name & Address*
    Please Write Branch Name & Address

  6. STUDENT’S PERSONAL INFORMATION

  7. First Name*
    Please Write First Name
  8. Last Name*
    Please Write Last Name
  9. Date of Birth*
    Please Write Date of Birth
  10. Gender*
    Please Select Gender
  11. Email*
    Please Write Email
  12. Address Line 1*
    Please Write Address Line 1
  13. Address Line 2*
    Please Write Address Line 2
  14. City*
    Please Write City
  15. State*
    Please select the state.
  16. Postal code*
    Please Write Postal code
  17. Telephone*
    Please Write Telephone
  18. Cell Phone*
    Please Write Cell Phone
  19. Fax
    Please Write Fax

  20. ACADEMIC INFORMATION

  21. University/Institute Name*
    Please Write University/Institute Name
  22. Degree*
    Please Write Degree
  23. Percentage*
    Please Write Marks
  24. Course*
    Please Write Course

  25. BTFS CHOICE OF COURSE

  26. Course Name
    Invalid Input
  27. Course Name
    Invalid Input
  28. Course Name
    Invalid Input
  29. Course Name
    Invalid Input
  30. Course Name
    Invalid Input
  31. If you press the submit button, it is taken as your signature and confirmation that the data provided above is true and correct.