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SUMMER COACHING PROGRAMME REGISTRATION FORM
Please fill the form below:
Enter your Email ID *
Skype ID *
Personal Information
First Name *
Last Name *
Gender *
Select
Male
Female
Age
(
e.g. 15yrs)
Date of Birth
(e.g. dd/mm/yyyy)
Mother Tongue
Parent's Name *
Parent's Occupation
Address for communication
Address *
City *
State *
Country *
Pin Code / Zip Code *
Residence Phone No. *
Mobile No.
School Details
Name of the School
currently studying *
Enrollment for
Board/University *
Select
CBSE
State Board
Coaching Programme Required
*
Speed Math/Vedic Math
(Please select Standard & Hours required)
Select Standard
Select
Sixth
Seventh
Eighth
10 Hours
20 Hours
30 Hours
Home Work/Doubt Clearing/Intensive Coaching
(Please select Standard, Subject & Hours required)
Select Standard
Select
Eighth
Ninth
Tenth
Eleventh
Twelfth
Mathematics
Chemistry
Physics
5 Hours
10 Hours
15 Hours
20 Hours
30 Hours
45 Hours
Additional Information
System Availability
Select
Yes
No
Internet Connection
Select
No
DSL
Broad Band
Dial-Up
Knowledge in Word/Excel
Select
No
Average
Good
Excellent
Knowledge in PowerPoint
Select
No
Average
Good
Excellent
Knowledge in Chat Tools
Select
No
Average
Good
Excellent
Typing Speed
Select
No
Average
Good
Excellent
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