REGISTRATION FORM Website: www.ksgindia.com, E-mail: drkhan@ksgindia.com 4. Nam PHOTO wit SIGNATURE, 2. Medium: English 3, Optional Subject: 4. Date of Birth: Date ‘Month Year Home TowniDistrict| 5. Father's/Mother’s Name: Occupation: 6. FULL ADDRESS Permanent: Local: 7. Coursels for which you (Please refer back page for the details of the ct 8, How have you come to know about KSG? in| Phone Pin| Phone one E-mail Parents [~] Friends Teachers [ |Newspapers [~ |Magazine Website Others| 2521, Ist Floor, Hudson Line, jay Nagar Chowk, Near G.TB. Nagar Metro Stn, Debi 110 009, Ph 611-4888 2607108, M: 9717 380 832 ‘M1, Old Render Nagar Mit, Above Syndicate Bank, Near Karol Bagh Metro Stn. New Delh-110 060 Tel: 011-4784 0303 8-5/4, Poors Marg, Old Ralencer Nagar, Opposite Gangaram Hospital, New Deln- 110 080, Tel: 011-4517 0303 M- 9841 298 743, No. 11616-1, 3rd Flor, KHB Colony Sth Block, Koramangala (Behind itel Ofice), Bengaluru, Kamataka- 560 085 Tel: 080 4854¢309, Mob. 7619 166 663 ‘Above Tyota Showroom, Exhibition Road, Near Gandhi Maidan, Patna- 800 001, Ph: 7463 980 774, M4: 9308 782 200 Plot No, 48, 1st Flor, Near Arya Bhawan Restaurant, MP. Nagar, Zone, Bhopal: 11 Ph: 755-4812 441, Nu: 7508 975 381 Plot No, 43, R.R. Arcade, 2nd Floor (S-1, &-2), (Behind GX Palace), MP. Nagar, Zone-I, Shopal-tt, Ph: 755-4077 441 282-229, nd Floor, Veda Bulking, Near Appa Hospital, Bhawarkua Square, Indre-O01, Ph: 781-4977 441, M: 9899 772.941 404, 4h Floor, Apex Tower, Lal Koh, Tonk Road, Jipur- 902 015, Ph 0141 4052 441, M8290 800 441 Counsellors Signature ‘Student's Signatures ‘age table bye nn andreas of Ka SoCo