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USE ENGLISH LANGUAGE TO FILL THIS APPLICATION FORM
( प्रवेश अर्ज इंग्रजी भाषेत भरणे अनिवार्य आहे)
Mobile Number (मोबाईल क्रमांक)
*
कृपया मोबाईल नंबर नीट तपासा. चुकीचा असेल तर नंतर बदलता येणार नाही.
Please Check the mobile number once again. It cannot be changed afterwards, if its wrong
Password
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Student's Name (विद्यार्थ्यांचे नाव)
*
Mother's Name (आईचे नांव)
*
Student's Date of Birth (विद्यार्थ्याची जन्म तारीख)
*
Date
Month
Jan
Feb
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Apr
May
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Jul
Aug
Sep
Oct
Nov
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Year
Parent's Full Name (पालकांचे पूर्ण नाव)
*
Email (ई-मेल)
Full Address (पूर्ण पत्ता)
*
Pincode (पिन कोड)
प्रेरणा सराव परीक्षे बाबत तुम्हांला कोठून माहिती मिळाली ?
Where did you get the information about Prerna Exam?
Representative (प्रतिनिधी)
Pamphlet / Brochure ( पॅम्पलेट )
Social Media ( सोशल मिडीया)
School / Tuition (शाळा / क्लासेस )
Friends (मित्र-मैत्रिणी)
Others (इतर)
Student's Photo विद्यार्थाचा फोटो
I confirm that all the information provided is correct and True as per my knowledge. I have read, understood and accept all the
Terms and Conditionsand
also promise to abide to them. I also grant permission to receive SMS from Prerna Educations on my registered mobile
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