Universal Institute

Name of the Applicant *(in BLOCK Letters)

Religion *

Caste *

Name of the Parent or Guardian *

Address *

Select Course *

Date of Birth *

Sex *

Male

Female

Occupation *

Phone Number *

Whatsapp Number *

School Last Studied *

10^th Marks/Grade

Kerala

CBSE

10^th Register Number

Stream Selected

Computer Science

Biology

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I promise to abide all the rules and regulations of the institute.
I permit all the authorities of Universal Institute, Kottakkal to publish my photo in newspaper and other media, in case of my success in any of the examinations.
I understand that the fees one paid shall be refunded as per the refund policy of the institute.
I understand that using mobile phone in the campus is strictly prohibited. Violators mobile will be conficcated.

Place *

Name of Applicant *

Date *

Name of Parent *

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