BrightPath Coaching Center

123 Education Lane, Knowledge City · +91 98765 43210

ADMISSION APPLICATION FORM

Course Applying For

Applicant Name * (in capital letters, as in the SSLC certificate)

Personal Details

Date of Birth

Age

Gender

Male Female Transgender

Email Address

Phone Number (Student)

WhatsApp Number

Phone Number (Parent)

Father's Name

Mother's Name

Religion

Caste

Qualification

Course	University / Board	Register Number	Year of Passing	% Mark

Address

House Name

Place / Village

Post Office

PIN Code

District

Photo

Passport-size photo. JPG / PNG / WEBP, up to 2 MB. Optional.

DECLARATION: I have carefully read the rules and regulations mentioned in the course prospectus and agree to abide by them. I declare that all the information furnished above is true to the best of my knowledge and belief. If any information is found to be incorrect, I agree to forfeit my claim for admission even if selected. I will produce the originals of all certificates and documents proving my eligibility as and when required.

I confirm that the above details are true and I accept the declaration.