REGISTRATION FORM

Student's Name *

Father / Guardian's Name*

Mother's Name *

Date of Birth*

Gender* Male Female Other

Blood * Select Blood Group NA A+ B+ AB+ O+ A- B- AB- O-

Programme * Select Programme Environmental Protection and Awareness

Address*

Pincode*

District* Select District Araria Arwal Aurangabad Banka Begusarai Bhagalpur Bhojpur Buxar Darbhanga East Champaran Gaya Gopalganj Jamui Jehanabad Kaimur Katihar Khagaria Kishanganj Lakhisarai Madhepura Madhubani Munger Muzaffarpur Nalanda Nawada Patna Purnia Rohtas Saharsa Samastipur Saran Sheikhpura Sheohar Sitamarhi Siwan Supaul Vaishali West Champaran

State* Select State Bihar

Nationality* Select Nationality Indian

Aadhaar No*

Religion* Select Religion Hindu Muslim Sikh Christian Jain Other

Category* GEN BC EBC SC ST

Mobile No*

WhatsApp No*

Email ID*

Course / Program* Select Course B.A. B.Sc. B.Com. Others

Honours Subject*

Semester* Select Semester I II III IV V VI VII VIII

College Name* Select College Nalanda Sodh Sansthan, Biharsharif MAHATMA BUDH HIRAMAN COLLEGE, PATUANA Others

University Name* Select University Patliputra University Others

Session* Select Session 2023-27

University Roll No*

University Registration No*

Place

Date