Registration | PRAKASH ACADEMY

Online Registration

Registration Date *

Student First Name *

Middle Name

Last Name *

Gender *

Date of Birth * (dd/MM/yyyy)

Place of Birth *

Category *

Father Name *

Father Mobile No. *

Mother Name *

Mother Mobile No.

Cast

Present Residential/Correspondence Address *

City *

Email *

Registration in Class *

Registration Fee *

Txn. Charge (2%)*

Registration Fee *

Upload Photo *
(.jpg/.png files are supported only.)

* Fee is not refundable

Permanent Address

Mother Tounge

Reg. Type

Father Name *

Mother Name *

Phone No.

Father Qualification

Mother Qualification

Father Occupation

Mother Occupation

Father Age

Mother Age

Father Designation

Mother Designation

Father Office Add.

Mother Office Add.

Father's Mobile No.

Mother's Mobile No.

Test Details
Test Date		Test Time		Test Result		Test Remark

Previous School Details

Previous Class

School

Medium

Board

%

Document Attach

TC

Birth Certificate

Report Card

Remark