Undertaking - C4YWebApp

Student's Family Name

Student's Middle Name

Student's First Name

Gender

Nationality

Student's Mobile Number

Student’s friends Mobile number in case of an emergency

Landline Number

Student's email ID *

Confirm student's email ID *

Permanent Address 1 *

Address 2

City

State

Parent/Guardian’s name

Parent/Guardian Address 1

Address 2

City

State

Residence Phone No

Mobile No of Parent/Guardian

Parent/Guardian’s Email ID

State in which the College is

Is it a Professional College or a General College

Name of the College

Name of Affiliated University

Director/Principal Family Name

Director/Principal First Name

Director/principal Gender

College Phone No. 1

College Phone No. 2

Under Graduate or Post Graduate

Name of the Course

How many students are in your Class

Year of Study

ANTI RAGGING - UGC