सामाजिक जन कल्याण परिषद

Registered under Societies Registration Act 21, 1860 | Reg. No.: 236 - 2010/2011

Ramchandrapur, Bihar Sharif, Nalanda, Bihar - 803101 | Phone: +91-7004850543 | Email: samajikjankalyanparishad@gmail.com

REGISTRATION FORM

Personal Details

Student's Name *

Father / Guardian's Name*

Mother's Name *

Photo Upload *

Max Size: 500KB
Formats: JPG, PNG

Date of Birth*

Gender*

Blood *

Programme *

Address*

Pincode*

District*

State*

Nationality*

Aadhaar No*

Religion*

Category*

Contact Details

Mobile No*

WhatsApp No*

Email ID*

Current Academic Details

Course / Program*

Major Subject*

Semester*

College Name*

University Name*

Session*

University Roll No*

University Registration No*

Declaration

I hereby declare that all the information provided by me in this registration form is correct, true and valid. I shall abide by the rules and regulations of the organization and institution during the internship period.

Place

Date