Hindustan

Full Name *

Age *

Date of Birth *

(dd-mm-yyyy)

Gender *

Place of Birth *

State *

Country *

Nationality *

Religion *

Mother Tongue *

Upload Passport Size Photo *

(File size to be within 100 KB)

Residential Address for communication *

Pincode *

Mobile Number *

Email *

Father's name *

Mother's name *

Occupation *

Annual Income *

Permanent Address *

Telephone No (with Code) *

Pin *

Email *

Name of Local Guardian

Telephone No (with Code)

Permanent Address

Email

Course Preferred *

10 th Standared or Equivalent

Year of Passing *

Affiliating Body/University *

12 Std/ PUC or equivalent

Year of Passing

Affiliating Body/University

Graduation level

Year of Passing

Affiliating Body/University

Do you want Hostel Accomodation ? *

Instructions:

1. All Students must fill up the Online Application Form and pay Rs 515/-. This amount will be discounted from the total course after Admission Confirmation.

2. Submitting Online Application Form only is not Admission Confirmation. Please read the Admissions Procedures.

3. After submitting the Online Application Form, the Student will receive a verification phone call and email detailing the Admissions Procedures to be followed.

4. For any further clarifications please speak to one of our Admission Counsellors – Mr PM Paul, Mr Benil Benjamin or Mr Inder Anand or post your query for Admission Enquiry here.

Declaration by the Candidate

I hereby certify that the information contained in this online registration form is complete and accurate, and I understand that submission of inaccurate information may be sufficient cause for denial of admission or termination of enrolment. I shall abide by the Rules and Regulations of the Academy.

ONLINE APPLICATION FORM

Do you want Hostel Accomodation ? * Select Yes No

Instructions:

Declaration by the Candidate

Do you want Hostel Accomodation ? *