Admission 2017 -2018
Instruction the applicant: Please fill this form in your own handwriting with adequate legibility. Use all capital letters and a blue or black point pen. Wherever applicable, fill one box leaving a blank box in between words. In complete forms and using a pencil or colours other than specified, to fill this form, along with required details mentioned should reach. The registrar of Institute at Uttam Palace,3, Sapru Marg, Lucknow 7 days before commencement of course.
Language :
Shift :  
Gender :  
Name :
Postal Address :
City :
Pin :
Phone :
Email-ID :
Father/SpouseName :
Do you hold any government or bank post as of today :  
If yes,specify details of institution City :
Experience,ifany ,as Recovery Agent(No. of Years?Month) :
Name & Add. Served as Recovery Adgent ,if applicable :
Date Of Birth :
Education,Qualification,including professional qualification if any :
Payment  Mode:  
Payment Details(in case of DD payment mode) :
DD Number DD Date  Amount Drawee Bank & Drawn On
 Picture :
Sponsor Name :
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