Application Form

Online Registration

ONLINE APPLICATION FORM
ADMISSIONS 2011

F39, Sector 6, Noida - 201301, (2nd Floor)
Tel : 9311122323, 9310122323
www.pran.in

Your Online Form will only be excepted when you send a Demand Draft of Rs 1,000/- (Rupees One Thousand Only). The draft is to be made in Name of “Pran’s Media Institute” payable at New Delhi. Mention your name and address at the back of the Draft.

Kindly courier it to:-
Principal,
Pran’s Media Institute,
F39, Sector 6, Noida – 201301.

Students Details :

Course Name:
Name:
Father's Name:		Mother's Name:
Date of Birth:	Day Month Year
Nationality:
Postal Address:

City:

State:

Pin:

Phone Number:

Mobile:

Sex:

Job Status:

Category:

Educational Qualification :

Exam Passed	University / Board	Year of Passing	Marks Obtained	% of Marks
10th Class
10 + 2
Graduation
Post Graduation
Others

Study Center :

I Would Like To Take Admission At

Course Type :

Permanent Course

Weekend Course

Correspondence Course

Declaration By The Applicant :

I hereby declare that I have read the institutes prospectus thoroughly and have understood the conditions of eligibility for the program for which I seek admission. I fulfill the minimum eligibility criteria and have provided necessary information in this regard. In the event of any information being found incorrect or misleading , my candidature shall be liable to be cancelled by the institute at any time and I shall not be entitled to the refund of any fee paid by me.

I also solemnly affirm to agree and abide by the rules & regulations, submit myself to disciplinary control and agree to make all payments in time. I accept the decision of management of PMI will be final and binding in all matters.

F39, Sector 6, Noida,
India - 201301. (Near Metro Station)
Ph: 93111-22323, 93101-22323
E-mail : pran@pran.in | www.pran.in