G.D STUDY CIRCLE

20/1 B, A K Md Siddique Lane, Kolkata – 700016, Near Ripon Street Bata More

Website : www.gdstudycircle.org * Email : gdacademykol@gmail.com

Phone (Head Office) : (033) 48031168

Technical Help for Online form fill-up – 7003257948 / 90511 86172

NEET & WBJEE FORM

Student Details

Name *

Gender *

Male Female

Blood Group

Caste

Date Of Birth *

Please use this date format: YYYY-MM-DD

Aadhar No

Admission In Stream *

Choice of Examination District *

Examination Center *

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Student Signature Upload *

Signature Upload jpg / png (Less than 50KB)

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Student Photo Upload *

Photo Upload jpg / png (Less than 50KB)

Choice of Missions which admission sought

List of Mission

Choice of Mission 1 *

Choice of Mission 2 *

Parent Details

Father's Name *

Father's Ocupation

Father's Qualification

Father's Mobile

Mother's Name *

Mother's Mobile

Mother Ocupation

Mother's Qualification

Annual Income

Contact Details

Phone No *

Village *

Block / Municipality *

District *

Post Office *

Police Station *

City *

Pin Code *

State *

Previous Exam Details

Name of Last Exam

Name of Board

Roll No *

Previuos School

Passing Year *