ENROLLMENT FORM
SESSION : 2022-2023
Enrollment No. / Unique ID No. :
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Main Center Atardah Kachi Pakki Road, Muz.
Mithanpura Center Muz.(Biology Only)
Regular Course
Select Course
1 Year Competitive Batch for XI
1 Year Competitive Batch for XII
Target Course (1 Year)
Crash Course (1 Month)
JRD Champs (Foundation)
Spoken English / personality Devlopment
JRD BIO Practical Center
Test Series (Online/Offline/CBT)
For Competitive Exam (SSC / Banking / Railway)
Zoology
STUDENT DETAILS
Applicant Name:
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Blood Group
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Mobile No
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Mobile No (Whats App Group)
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Email
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Aadhaar Card Number
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Temporary Address
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Permanent Address
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How did you come to know about JRD Classes
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PARENTS DETAILS
Father Name
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Mother Name
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Father Profession
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Mother Profession
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Father Mobile No.
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Mother Mobile No.
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SCHOOL DETAILS
School / College Name
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School Address
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Educational Qualification
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Class
Board
% Of Grade
School / College
Subject
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Parents Signature
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Candidate Signature
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I hereby declare, that the particulars submitted by the online application form of
JRD Classes
are true to the best of my knowledge.
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