Online Admission Form


Note: Fields marked with * are compulsory

COURSE INTERESTED IN (*)
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PERSONAL DETAILS (In Block Letters)
First Name (*)
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Middle Name (*)
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Last Name (*)
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Date Of Birth (*) / /
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Age (*)
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Gender (*)
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Student's Email (*)
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Student's Mobile (*)
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Parent's Information

Father's Name (*)
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Father's Mobile (*)
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Father's Email Id (*)
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Mother's Name (*)
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Mother' Mobile No. (*)
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Parent's Profession (*)
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Designation
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Annual Income
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Address Information

Present Address (*)
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City (*)
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PinCode (*)
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State (*)
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Country (*)
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Permanent Address
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City (P)
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PinCode (P)
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State (P)
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Country (P)
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Telephone(R)
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Telephone (O)
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Emergency contact No. (*)
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Whether You Belong to (*)
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Passing Examination (*)
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Nationality (*)
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Passport Number
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Visa Details(If Applicable)
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Date Of Arrival in India (If Applicable)
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Educational Information

SSC
Board (*)
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School Name (*)
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Degree (*)
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Year Of Passing (*)
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Subject Specialization (*)
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Marks in % (*)
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HSC
Board (*)
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College Name (*)
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Degree (*)
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Year Of Passing (*)
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Subject Specizlization (*)
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Marks in % (*)
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Diploma
Board/University
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College/Institute
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Degree
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Year Of Passing
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Subject Specialization
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Marks in %
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Degree
Board/University
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College/Institute
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Name Of Degree
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Year Of Passing
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Subject Specialization
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Marks in %
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PG Degree
Board/University
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College/University
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Name Of Degree
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Year Of Passing
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Subject Specialization
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Marks in %
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Other Course
Board/University
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College/University
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Name Of Course
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Year Of Passing
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Specialized Subject
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Marks in %
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Computer Literacy (Packages known) (*)
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Details of work Experience (If any)
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Sports/Extra-Curricular Activities (*)
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Career Goals (*)
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Mention Your Strengths & Weakness (*)
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Why do you think PIAT is best option for you? (*)
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From where did you get to know about PIAT? (*)
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Any Other Source
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Provide Information about your Family (Not more than 50 words) (*)
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Health Information

Height (*)
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Weight (*)
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Blood Group (*)
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Any major ailment or continuing health problem
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Photo (*)
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(*)
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Submit   
    Enquiry
    • First Name(*)
      Please let us know your name.

      Last Name(*)
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      Email Id(*)
      Please let us know your email address.

      Mobile No(*)
      Please let us know your mobile no.

      Message(*)
      Please let us know your message.

    2 Quick