UDAAN ACADEMY
STUDENT REGISTRATION FORM
Reference Name
Leave it blank if not known
Basic Information
Student Name
*
First Name
Surname
Email
*
Mobile Number
*
-
Code
Number
Alternate Number
-
Code
Number
Address
*
Door/Flat/Plot No.
Street Name, Location/Area Name
City Name
State / Province
Postal / Zip Code
Personal Information
Gender
*
Male
Female
Transgender
Date of Birth
*
-
Day
-
Month
Year
Height (in Centimeters)
*
Weight (in Kilograms)
*
Aadhar Card Number
*
Do you have a Passport ?
*
Yes
No
Passport Number
Do you wear spectacles ?
*
Yes
No
If YES - Mention lens powers of both eyes
Do you have any disability ?
*
Yes
No
If YES - Mention in details
Parents Information
Father's Name
*
Contact Number
Father's Occupation
Mother's Name
*
Contact Number
Mother's Occupation
Educational Qualifications
Tick all as applicable
*
Below 10th
10th Pass
+2 Pass
Degree Pass
Highest Qualification Pass Year
*
Name of Board/University
*
Medium of Language
*
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