Admission Cyber Security Course in Pune

A) GENERAL INFORMATION

Name

Contact Email

Contact No

Alternate Contact No.

(Ensure your contact no. is correctly recorded as Suryadatta sends many important messages via SMS. Any change in Address / Contact No. / Email must be communicated to Suryadatta immediately.)

Date Of Birth

Age (as on 1st July 2023)

Gender

Nationality

Religion

Father / Guardian’s Name

Professional Background of Father/Guardian

Designation (Father/Guardian)

Mobile No. (Father/Guardian)

Residence No.(including STD Code)

Mother Name

Professional Background of Mother

Designation (Mother/Guardian)

Email Id (Father/Mother/Guardian)

Alternate Email Id (Father/Mother/Guardian)

Family’s Yearly Income

Sources of Income

Do you have any Brother(s), Sister (s). If so, their name & present occupation

B) POSTAL ADDRESS

Communication Address

Country

State

City

Pin Code

Permanent Address

Country

State

City

Pin Code

C) DETAILS TO BE FILLED BY FOREIGN STUDENTS

Passport No.

Passport Issued

Valid Till

Visa No.

Visa Type

Valid Till

Nationality

Country

Any Relative in Pune / India: Name

Relationship

Contact No.

Email Id

Address

University Exam Given

D) ACADEMIC DETAILS (DEGREE / DIPLOMA)

It is mandatory to mention your academic details, without which, your form will not be processed.

10th Board Exam :

12th Board Exam :

Diploma, if any :

Graduation Specify :

Other Examinations (Please specify) :

Computer Literacy

E) INDUSTRY WORK EXPERIENCE IF ANY

Experience 1:

Experience 2:

F) EXTRA-CURRICULAR ACTIVITIES

This is not a compulsory part. Only those claims which can be substantiated with legitimate certificates need to be mentioned here. Attach separate sheet if required. List not more than three significant achievements in extra-curricular activities.

Activity 1

Activity 2

Languages Known
English Hindi Other

Hobbies & Interest

Mention your Strengths and Areas of Improvement

Why do you think SURYADATTA is the best option for you?:

Health Records

G) OTHER DETAILS

a) Category
Gen / Open SC ST OBC VJ.NT / VJ.DT SEBC Jain Minority Others

If from reserved category, attach Non Creamy Layer, Cast Validity Certificate from competent Govt. authorities.

Yes No

b) Are you attaching your Domicile & Nationality Certificate

Yes No

c) Are you a physically handicapped candidate : If yes, attach disability certificate from competent authorities.

Yes No

d) Are you an outstanding performer in Academics (Medalist or Rank Holder) in the University / Board. If yes, attach supporting document signed by competent authorities

Yes No

e) For Master Degree courses : Have you passed your Bachelor’s Degree from a recognized University?

Yes No

f) Did you have any gap in your continued education. If yes, attach your gap certificate stating reasons for the same.

Yes No

Your source of information about our Course : (Please tick wherever applicable)

a) Newspaper advertisements

Yes No

b) Magazine

Yes No

c) Internet

Yes No

d) Alumni

Yes No

e) Current Students

Yes No

f) Parental Reference

Yes No

g) Any Other Source

Hostel Facility :
Only Boarding Boarding & Mess No

Preferred mode of Payment for fees :
Own Source Education Loan

Documents to be submitted - Copies only

1. Mark sheets of all examinations

2. Transfer Certificate & Migration Certificate

3. Valid Proof of Address (Submit Photo Copy of any one of the following document)

Driving Licence Passport Voters ID Aadhar Card Ration Card

4. Upload Passport Size Photograph (Max file size : 1MB , Allow file type : jpg,jpeg,png,pdf only. )

H) RULES & REGULATIONS

Read Rules & Regulations Click here

I) DECLARATION

I Confirm that above information is correct and have read the rules and regulations carefully and will follow the same.

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