Patidar Career Academy

Onetime Registration Form

Student Type

STUDENT TYPE: *

BASIC DETAILS

First Name *

Father Name*

Surname *

Sub Caste *

Gender *

Native Place *

Mobile Number*

E-mail *

Marital status *

Guardian Mobile Number*

Date of Birth *

Age *

Blood Group *

Permanent Address *

State *

City(District)*

Taluka*

Pincode *

Is Correspondance Address same as Permanent Address

Correspondance Address *

Correspondance State *

Correspondance City (District)*

Correspondance Taluka*

Correspondance Pincode *

Is Physically Challenged *

Passport Sized Photo (max: 800kb) *

Leaving Certificate (max: 2mb) *

ID Proof Type*

ID Proof No *

ID Proof(બંને બાજુ)(max: 2mb) *

Exam Application (max: 2mb)

CARRIER PROGRESS

SSC (max: 2mb) *

Year *

SSC / Board *

SSC percentage *

HSC /Diploma (max: 2mb) *

Year *

HSC / Diploma *

HSC / Diploma percentage *

Graduation (max: 2mb) *

Graduation Name *

Year *

Board / University / Institute *

Graduation percentage *

Other (max: 2mb)

Other Name

Year

Board / University / Institute

Other percentage

Job Details

Institute / Company

Designation / Position

Work Duration

Competitive Examination Records

Examination

Year

Post

Status

* I hereby declare that the details furnished above are true and correct to the best of my knowledge. I shall abide by the rules and regulations of the institute. The institute can use my candidature to recognize the performance of the institute.
(હું જાહેર કરું છું કે ઉપર આપેલી તમામ વિગતો મારી જાણકારી મુજબ સાચી અને યોગ્ય છે. હું સંસ્થાના નિયમોનું પાલન કરીશ તેમજ સંસ્થા મારી કામગીરીનો ઉપયોગ સંસ્થાના પ્રભાવને ઓળખવા માટે કરી શકે છે.)

Student's Full Name:
Sub Caste:
Gender:
Mobile:
Email:
Father Mobile:
Date of Birth:
Blood Group:
Age:
Permanent Address:
State:
City:
Pincode:
Correspondance Address:
Correspondance State:
Correspondance City:
Correspondance Pincode:
Is Physically Challenged:

Basic Details

Career Progress

Job Details

Competitive Examination Records

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