Online Admission Form - Minerva Institute

Passport Photo * (3.5 x 4.5 cm)

Name *

Father's Name *

Permanent Address *

Current Address *

Mobile No. Student *

Guardian Phone Number *

Email Id

Date Of Birth *

Resident *

Category *

Course *

Joining Year *

Last Qualification

	10th	10+2	Other
Name of the qualifying Examination
Year
Name of the Institution
University/Board
Div/Precen

DECLARATION BY THE APPLICANT
I hereby declare that all particulars stated in the application are true to the best of my knowledge and belief. I have read & understood all the provisions of the prospectus and agree to abide by them. In the event of suppression or distortion of any fact like educational qualification, nationality,study period etc. Made in this application form,I understand that my registration / admission liable to the cancelled of any stage.

DECLARATION BY THE APPLICANT

I hereby declare that all particulars stated in the application are true to the best of my knowledge and belief. I have read & understood all the provisions of the prospectus and agree to abide by them. In the event of suppression or distortion of any fact like educational qualification, nationality,study period etc. Made in this application form,I understand that my registration / admission liable to the cancelled of any stage.

10th/12th/Graudution Marksheet

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10th/12th/Graudution Marksheet

ID Proof of Student

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ID Proof