Zetta Career Institute
Call us: 0172-5016977
+91-7901745990
Email : info@zci.co.in
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XII Regular IIT-JEE Coaching in Chandigarh
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B.Sc. (Nursing)
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Registration Cum Admission Form
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STREAM:
*
MEDICAL
NON MEDICAL
*
two Year {+1&+2}
One year {+2} Only
foundation {ix/X}
foundation {ix/X}
Crash Course/Dropper
Weekend
Morning D
Morning S
Evening
Student Name
*
First
Last
Date of Birth
*
Gender
*
Male
Female
Father's Name
Father Occupation
Mother's Name
Mother Occupation
Guardian's Name
Guardian's Occupation
Permanent Address:
If between grades, list the grade the cheerleader will be in at the start of the next school year.
Correspondence Address:
If between grades, list the grade the cheerleader will be in at the start of the next school year.
City
pin Code
Phone {Father}
*
phone {mother}
Student {phone}
*
Phone for SMS
Email
*
ACADEMIC DETAILS
CBSE
ICSE
PB
HRY
HP
OTHERS
Name
*
CLASS
SCHOOL
Submit
