IICS

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.