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REGISTRATION FORM
TERA ACADEMY OF PROFESSIONAL EDUCATION

STUDENT DETAILS
NAME:

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CONTACT NUMBER

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EMAILID:

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PRESENT ADDRESS:

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PERMANENT ADDRESS:

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DATE OF BIRTH:

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EDUCATIONAL DETAILS
PROFESSIONAL QUALIFICATION: tick the appropriate one
BE/BTECH/MSc

MTECH

DIPLOMA

Completed

Pursuing

BRANCH:

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NAME/ADDRESS OF COLLEGE:

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CGPA

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CLASS XII PERCENTAGE

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CLASS X PERCENTAGE

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Students Signature
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COURSE OPTED AT TERA: tick the appropriate one

VLSI DESIGN
PCB DESIGN
ANDROID BASED MOBILE APPLICATION DEVELOPMENT
SAP
A Brief about why you opted for particular course

DATE:

Students Signature
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