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Application Form

PLEASE FILL THE FORM BELOW

First Name *
Last Name *
Gender *
Date of Birth (dd/mm/yyyy) *
Photo *
Permanent Address *
City *
Pincode *
Mobile *
Alternate Mobile
Email ID *
Alternate Email Id
  Click Here, If Permanent Address is same as communication Address
Address for communication *
City *
Pincode *
Preferred Class Location *
Source of Information
Total work experience *
EDUCATIONAL HISTORY (H.SC ONWARDS) Start with Last Education Qualification
Name of Examination Institute/University Specialization/Branch Year of Completion % of Marks
WORK EXPERIENCE DETAILS (UP TO DATE) Start with the Latest Work Experience
Company Designation From (DD-MM-YYYY) To (DD-MM-YYYY) Duration in Months Job Responsibility


TILL NOW   
Salary Band *

I HEREBY AGREE TO THE FOLLOWING TERMS AND CONDITIONS

I HAVE READ THROUGH THE INSTITUTES PROGRAMME DETAILS AND ELIGIBILITY CRITERIA AND HEREBY DECLARE THAT I COMPLY TO THE SAME. I CONFIRM THAT ALL THE PERSONAL, ACADEMIC AND WORK EXPERIENCE INFORMATION, ACCOMPANYING ATTACHMENTS AND ENCLOSURES ARE TRUE TO THE BEST OF MY KNOWLEDGE. IF ANY STATEMENT IS INCONSISTENT OR ANY INFORMATION PROVIDED IS NOT IN LINE WITH THE DOCUMENTS PROVIDED LATER OR FOUND TO BE INCORRECT, MY APPLICATION AND SUBSEQUENT ADMISSION WILL STAND CANCELLED AND NO MONEY WILL BE REFUNDED. I AGREE THAT THE INSTITUTE OR UNIFIED COLLABORATION SERVICES LLP CAN REJECT MY APPLICATION WITHOUT ASSIGNING REASONS FOR THE SAME AND THAT ALL FEES PAID ARE NON-REFUNDABLE OR NON-TRANSFERABLE .