Name : PLEASE AFFIX YOUR RECENT PASSPORT SIZE COLOUR PHOTOGRAPH & SIGN ACROSS
Regn. No. :
Course Selected :
Address (Gulf) :
Phone Number :
Address (Local Guardian) :
Phone Number :
Hostel Opted :  
DD No. :  
Name of Bank & Branch where DD drawn :  
Date :  

 

Signature

 

NOTE : DD attached with this registration details should be received within 15 days to the address given below. Otherwise the admission will be cancelled.

To,
The Coordinator
Gulf Batch
Brilliant Study Centre
Puliyannoor P.O., Pala

Kerala, India, 686573
Helpline Number : +91 97442 29127