REGISTRATION FORM FOR KOJO CODING PROJECT

(Please Tick ‘√’ whichever is applicable, Write in capital Letters only and Leave one blank between Words)
1. Name of Student (As in Matriculation Certificate) (In Block Letters)

2. Father Name (In Block Letters)

3. Mother’s Name (
4. Father Contact :

MALE
5. Gender
FEMALE
6. Category SC ST OBC GEN
7. Religion MUSLIM CHRISTIAN SIKH BUDDHIST PARSI HINDU OTHER

8. Marital Status SINGLE MARRIED WIDOW WIDOWER DIVORCE

9. Educational qualification __________________________

10. Aadhaar NO;

11. Date of Birth (In Christian Era, DD/MM/YYYY format)

12. Address of Applicant (In Block Letters)

14. Email Address (if any)

15. Contact Number (if any)

16. Father Occupation

17. Parental Annual income

18. Type of ID Proof:’ ID Proof Number

19. College /HSS name

20. Family Size Job Preference location 1. 2

I hereby certify that, the information furnished above is true. I to the best of my knowledge and nothing has been concealed or suppressed there in I also under take
hat I shall abide the rules and regulations of the institute
Date :

Place : Signature of Applicant