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Name : *

Roll No : *

Sem : *

Batch(Passing year) : *

Email : *

Mobile No : *

Gender : *

MIS Login UID : *

Date Of Birth : *

Enrollment No: *

State : *

City : *

Postal Code : *

Address : *

Father Name : *

Mother Name : *

Father Occupation : *

Mother Occupation : *

Occupation Details : *

Mention Company Name

Occupation Details : *

Mention Company Name

Father Contact No : *

Mother Contact No : *

Operating System Known: *

Hobbies *

Goal (For current year) *

Are you interested to be a mentor for junior students? *

If Yes Specify Stream

Higher Studies Enthusiast ? *

If Yes, Type?

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