IICS

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IICS - Indian Institute of Computer Studies logo


    INDIAN INSTITUTE OF COMPUTER STUDIES

    Managed by Gayatri Educational Trust
    Tulasichoura, Baripada, Mayurbhanj

    Examination From


    Name of the Examination*
    Name of the Center*
    Registration Number*
    Date of Form Fillup*
    Name of the Course*
    Name of the Student (in block letter)*
    Date of Birth*
    Name of Father (in block letter)*
    Name of Mother (in block letter)*
    Name of the Guardian if any (in block letter):*
    Address
    Mobile No
    Annual In-come of Parents (Rs)
    Caste
    Religion
    Nationality*
    Education Qualification
    Fees paid up to Month & Year*
    No. of Days / Class attended
    Whether pupil phsically disabled*
    Whether visually physically disabled*



    Date Signature of the Student (Upload in jpg, jpeg, png format within 500kb)

    Note: You will be intimated by management after submission.