Student Application Form | Jigyasha Career Counselling

Course Applied For *

Course Name *

Specialization

Name of the Candidate *

Full Name * (as in Class X marksheet)

Father's / Husband's Name *

Full Name *

Category *

GEN OBC SC ST Minority

Correspondence Address *

Address *

City *

State *

PIN Code

Country

References

E-Mail ID *

Email Address * (Only in CAPITAL LETTERS)

Phone Number *

Mobile No. *

Alternate / Parent's Mobile

I hereby declare that all information provided is true and correct. I understand that any false information may lead to cancellation of my admission. *

Registration Fee

₹499 one-time

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