Jaipuria - My Application Form

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Application Form

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Phone No.

Email Address

First Name

Last Name

Date of Birth

Blood Group

Nationality

Category:

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Class 10th Details

Passing Year

School / Institute

Percentage / Grade

Class 12th Details

Passing Year

School / Institute

Percentage / Grade

Stream

Graduation Details

Passing Year

College / University

Stream

Percentage Marks

Entrance Exam Details

Entrance Exam Test

Registration Number

Month/Year

Entrance Test Score

Father Details

Father's Name

Father's Mobile

Father's Email

Father Occupation

Mother Details

Mother's Name

Mother's Mobile

Mother's Email

Mother's Occupation

Family Details

Family Income

Complete Address

City

State:

Pin Code

Source of Information

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Jaipuria Institute of Management, Noida

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