Lead Registration

Full Name *

Gender *

Parent/Guardian Name *

Address *

Mobile Number *

Alternate Contact Number (optional)

Email ID *

PIN Code *

District *

Current Institution / College / School *

Academic Result *

Percentage *

Preferred Course / Program (choose up to 3) *

Do you wish to attend the Campus Tour? *

Yes

Number of People Attending With You *

How did you hear about the Open House? *

I agree to receive event-related communication from the University. *