Electronic Admission Form



Apply For*
01. Full Name*
02. Father’s/Husband’s Name*
03. Mother’s Name*
04. Present Address*
05. Permanent Address*
06. Email*
07. Contact Number Self*
08. Contact Number Father*
09. Contact Number Guardian
10. Date of Birth*
11. Religion
12. Nationality
13. Who will be paying fees ?* Self Parents Guardian
14. SSC Mark Sheet
15. HSC or O Level Mark Sheet
16. Graduation or A Level Mark Sheet
17. Masters Mark Sheet
18. Birth Certificate/Passport
19. Photograph
20. Electronic Signature

Terms & Conditions :

 
I hereby declare that all the above form has been filled up by myself and all information provided are utmost true. All my certificates and mark sheets are original.
 
NOTE: There will be no refund of any payment once made by the student to Bhuiyan Academy. I do agree with the above terms and conditions as a student of Bhuiyan Academy.