mpsamroha@gmail.com | +91-7536892612

ONLINE REGISTRATION FORM FOR SESSION 2020-21

STUDENT'S DETAILS

Enter Your Full Name


Applying for Grade:


Please select grade.
Gender: MaleFemale

Date of Birth:

Please select date of birth of student.

Category:

Please select category.


Please enter full name of your previous school.

Previous Class:

Please select previous class.


Please enter your full permanent address here.


Please enter your full present address here.

MOTHER'S DETAILS

Enter Mother's Name.

Please select mother's date of birth.

Enter Mother's Occupation.

Please enter mother's mobile number.
Please enter a valid mobile number.

Please enter mother's email id.
Please enter an valid email id.

FATHER'S DETAILS

Enter Father's Name.

Please select father's date of birth.

Enter Father's Occupation.

Please enter father's mobile number.
Please enter a valid mobile number.

Please enter father's email id.
Please enter an valid email id.


Upload Documents

STUDENT'S

PASSPORT SIZE PHOTO


Please upload image only.
Please upload image less than 1 MB.
This field is required!

AADHAR CARD


Please upload pdf/jpg/jpeg only.
Please upload file less than 2 MB.
This field is required!

BIRTH CERTIFICATE


Please upload pdf/jpg/jpeg only.
Please upload file less than 2 MB.
This field is required!

LAST CLASS REPORT CARD


Please upload pdf/jpg/jpeg only.
Please upload file less than 2 MB.
This field is required!

TRANSFER CERTIFICATE


Please upload pdf/jpg/jpeg only.
Please upload file less than 2 MB.
This field is required!



MOTHER'S

PASSPORT SIZE PHOTO


Please upload image only.
Please upload image less than 1 MB.
This field is required!

AADHAR CARD


Please upload pdf/jpg/jpeg only.
Please upload file less than 2 MB.
This field is required!



FATHER'S

PASSPORT SIZE PHOTO


Please upload image only.
Please upload image less than 1 MB.
This field is required!

AADHAR CARD


Please upload pdf/jpg/jpeg only.
Please upload file less than 2 MB.
This field is required!




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Mesco Institute of Pharmacy