Pre-Registration Form APPLICANT INFORMATIONFirst Name*Middle NameLast Name*Gender*MaleFemaleOthersPhone No. ☎️*Mobile No. 📱*Address* Street Address City State / Province / Region Email Address 📧* Date of Birth(AD) 📅 Date Format: MM slash DD slash YYYY Date of Birth(BS) 📅Parent/Guardian's DetailsFather's Name*Father's ProfessionFather Mobile no*Mother's Name*Mother's ProfessionMother's Mobile noLocal Guardian's NameRelation with Local GuardianLocal Guardian's Mobile noCourse DetailsProgram You are going to enroll into:*B.Sc.CSITBCABBMBBSAcademic Information+2 or EquivalentInstitution Name*CGPA / %*Major SubjectsUpload Your Photo:Accepted file types: jpg, gif, png, pdf, jpeg.CAPTCHAPost Title EmailThis field is for validation purposes and should be left unchanged.
