MY WEB PAGE

NILKANTH COMPUTER INSTITUTE Mandir Mahewa, Etawah-206128(U.P)India
9410206155, 9457376812, 8410461046
Application Form
sr.no ...................
Sesion:2024-25

Course Details:

Course applied for___________________Date__________________

Personl Detaile:

Candidate Name (Capital Latter):

Father Name's(Capital Latter):

Date of Birth:

Gender (Tick):

Male: Femal

Category (Tick):

Genral: OBC : SC: ST:

Permanent address (Capital Latter):

Home No.

Mobil No.

Nationality:

Adhar card No.

Email Id.

Academic Qualification (photocopies-10,12th Mark sheet,Adhar card and photo):

Sn.	Examination passed	Name of board/university	Year	Obt.Mark	Total Mark	%
1.	10th
2.	12th
3.	Graduation

Declaration by the candition:

I decleare that the information given above is true and complete to the best of my knoeledge&belief, and if any of it found to be incorrect my admisstion shall stand cencelled and I shall be liable to such disciplinary action as many be decided by the institute . The decision of the institute there on shall be final

---

---

______________________
Left Thumb Impression

___________________
Signature Of Student