Student Registration Form for NICE Courses

Instructions: Fields marked with *(asterisk) are Mandatory Fields.
Enter In Format (DD-MM-YYYY) otherwise application will be rejected
Login Details will be Mailed to this Email ID
Login Details will be send to this Mobile Number
First Name :
Last Name :
Student Father's Name :
Student Mother's Name :
Gender :
Date Of Birth :
Email ID :
Mobile Number +91 :
Alternate Mobile Number +91 :
Select Course :
House No. / Building / Street / Premises / Area / Post Office :
Taluka / Tehsil / Block :
District :
State :
PIN Code :

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