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Family name
As in passport

Given name:
As in passport

Father’s name / occupation

Date of Birth

(dd/mm/yyyy)

Sex
Passport No ( for records only )
Complete Address (permanent and correspondence)
City
Pincode
Phone
Mobile
email

Educational qualifications:
Academic background with percentage of marks 10th onwards.

IELTS taken: Date and Score
leave the space blank if IELTS not taken

Work experience: Details of Employer: Period (specify dates)

Area of interest
Kindly specify area/subject of interest eg. Diploma, Bachelors or Masters
Preferred Start Year












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