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Student Registration Form
Course Name :SH
Batch Name :SH-05
Start Date :06-Jan-2018
Timing : 10:00 AM - 4:00 PM
Total Fees :9800.00
No. of Registrations Avaliable :37
Student's Name :
First Name Father's/Middle Name Last Name
Enter Your Name on Certificate :  
[Note: Enter your name to be printed on Sunbeam Course Certificate]
Gender : Date of Birth:
Permanent Address :
Select State:
Select City:


Enter Address:

[Note: Do not enter City/State/Pincode in address field]
Enter Pincode:
Enter Primary email-id :      
Contact No :
Phone No.
ISD STD Phone
Mobile
    
Do you have LAPTOP?