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[academia_heading title=”ONLINE ADMISSION FORM” title_size=”fs-18″]

Name in Full

Surname
First Name
Father’s/Husband’s Name
Mother’s Name


Address
A. Correspondence
B. Permanent
Date Of The Birth
Place of Birth
Contact Number
Emergency Cont. Number
Email ID
Alternate E-mail id
Gender
Marital Status
Social Category
Caste Certificate
Caste Validity
Non Creamy Layer
Physically Handicapped

UNDERTAKING

I understand and agree that the registration fee is neither transferable nor refundable.

We do hereby confirm that above mentioned information is true to the best of my knowledge.

Person Name
Date
Student Name

PAYMENT DETAILS:

For confirmation of admission kindly pay the registration amount. Online Payment Details are mentioned below.


Account Name: Dnyan Ganga Education Trust

Bank Name: NKGSB Bank Ltd

Account Number: 107110600000001

Branch: KAVESAR, GHODBUNDER ROAD, THANE

IFSC Code: NKGS0000107

CONFIRMATION OF SUCCESSFULLY RECEIVED PAYMENT

Online Transaction Details:

Name of the Bank
Transaction Id
Date Of Transaction
Amount Paid