Register

Personal

Name

Form No

Gender

Male
Female

Caste

Date of Birth

Father

Name

Mobile No

Mother

Name

Mobile No

Passport Photo

Academics

X School

X Board

X Board Year

XII School

XII Board

XII Board Year

Current Class

Medium

Prerna Classes Ex student

Prerna Roll No

Percentage Marks Obtained in the Last Pre-Board/Board Examination (as applicable):

When you have Science as a subject/paper

Maths

Science

When you have Maths, Phyics & Chemistry

Maths

Physics

Chemistry

Present Address

H.No. & Street

Locality

City / District

State

Student's Residence

Local
Outstation

Preferred Batch at Prerna

Morning
Evening

Permanent Address (if different from Present Address)

Permanent Address

H.No. & Street

Locality

City / District

State

Payment Details

Payment Type

Cheque/DD/Transaction No

Cheque/DD/Transaction Date

DD/Cheque Issued by Bank

Bank Branch

Amount