CONTACT US

Palriwala Vocational Training & Research Institute (Pvt.) Industrial Training Institute,
Near Railway Station, Basani Road, Lachhmangarh-332311 Distt-Sikar (Raj.)
Contact: +91-1573-222220. Telefax: +91-1573-222240.
E-Mail: perts.iti@gmail.com
pvt_iti_p295@yahoo.in

    Student Registration Form

    STUDENT REGISTRATION FORM

    FIRST NAME


    (max 30 characters a-z and A-Z)

    LAST NAME


    (max 30 characters a-z and A-Z)

    DATE OF BIRTH

    EMAIL ID

    MOBILE NUMBER


    (10 digit number)

    GENDER

    Male
    Female

    ADDRESS

    CITY


    (max 30 characters a-z and A-Z)

    PIN CODE


    (6 digit number)

    STATE


    (max 30 characters a-z and A-Z)

    COUNTRY

    HOBBIES

    Drawing

    Singing

    Dancing

    Sketching

    Others

    QUALIFICATION

    Sl.No.

    Examination

    Board

    Percentage

    Year of Passing

    1

    Class X

    2

    Class XII

    3

    Graduation

    4

    Masters

    (10 char max)

    (upto 2 decimal)

    COURSES
    APPLIED FOR

    BCA

    B.Com

    B.Sc

    B.A