Please fill the complete form. Fields with "*" are mandatory to fill.
If you
do not know the answer of any field, you can put "Not Applicable" or "NA".
Information Source: *
Newspaper Social Media School Staff Top Neurons Team Youtube Whatsapp msg
Others
Student Full Name: *
Kamal Sharma
Gender: * Male Female
Category: * General OBC SC ST
If you have any disability like Deaf,
Are your physically handicapped? : * Yes No Dumb, Loss of Hand etc., fill Yes
Date of Birth * (DD/MM/YYYY)
01/01/2007
Email ID (All important communications will be sent on the given email ID) *
Please double check your email address
You will receive all information on
emails hence fill the correct
kamal.sharma@gmail.com
information.
Primary Mobile No. (Please fill your primary number on which all communications will be done) *
9828433692
Secondary Mobile No: (If you are using alternate number please fill in this field)
If you do not have any other number leave it blank
Do you have whatsapp mobile number? *
Yes No
9828433692
Residence Address *
State *
Rajasthan Select your state from the list
District (Please choose option other if your district is not in the list *
Jaipur Select you district after selecting the state
Pincode
302019
Father Full Name (If father is not alive, please put "late" before his name) *
Father Occupation
Father Mobile No.
9828474156
Mother Full Name (If mother is not alive, please put "late" before her name) *
Mother Occupation (you can put 'House Wife' if your mother is not in job)
Housewife
Mother Mobile No.
Combined Annual Income of parent Approx (in full digits i.e. 60,000 or 1,50,000 etc.) *
200000
Which class you are Currently Studying in *
Class X (Session 2021-2022)
Currently Studying School Name: *
Currently Studying School Address: *
Current School Type * Government Semi-Government Private Govt Aided
Board of education where you will give class X exam: *
Current Medium in School * Hindi English Others
Which Primary stream you would be choosing for career and would like to take coaching in *
Engineering( JEE ) Medical (NEET) Not Yet Decided
If you have not decided what Subject you will take in Class XI then select Not Yet Decided
Which medium of instruction you are planning to go in Class XI & XII( Ex Hindi, English, If you do not
know you can write 'Not Yet Decided'): *
English
Which medium of instruction you would like to take coaching in (Please Note: currently we are
planning to take classes in English only , but if we have Lot of numbers , we may think of running Hindi
medium classes too.) *
English Hindi
In case you get selected for offline classes at centre in Jaipur, would you be able to join classes in
Jaipur, Rajasthan, free accommodation will be provided by Top Neurons? (Please note offline classes
will be provided in Jaipur only) *
Yes No I am not sure
How much you have secured in Class 8th? (Please write down exact remarks mentioned in your
marksheet) You can only choose one option from the below options: *
CGPA
Grade (Fill the exact details mentioned in the marksheet)
Percentage
Other
Class 8th Marksheet:
Choose File grade-sheet-class-8-ble-copy-780x1024.jpg
Remove
100%
Percentage/Grade Secured in Class 9th (You can fill either grade or percentage or both as per your
marksheet)
(Fill the exact details mentioned in the marksheet)
Class 9th Marksheet:
Choose File grade-sheet-class-8-ble-copy-780x1024.jpg
Upload 9th Class Marksheet. If you
don’t have it currently, kindly move
to the next step.
Remove
100%
Student 12 Digits Adhar Card Number : *
543289784561
(Fill the exact details as per Adhar Card)
Front page Aadhar card: *
Choose File grade-sheet-class-8-ble-copy-780x1024.jpg
Check all the filled details
carefully, once you have verified
all the details kindly save and
submit
