Placement Registration Form

Select Placement Drive *
University Enrollment No *
First Name *As per Highschool certificate
Last Name
Father Name *As per Highschool certificate
Mother Name *As per Highschool certificate
Date of Birth *dd/mm/yyyy
Gender *
MaleFemaleOther
Mobile Number *
Alterrnate Mobile No
Father Mobile No
Email ID *
College Name *
Course *
Branch (if Any) *
Year *
10th (%) *
Year Of Passing (10th) *
Board
Select 12th/Diploma *
Year Of Passing (12th/Diploma)
Board
UG (%) *
Year Of Passing (UG)
Board/University
PG(%)
Year Of Passing (PG)
Board/University
Current Backlog *
History Backlog *
Present Address *
Internhsip Details ( If Any)
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

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