Library Registration Form - Shree Saurashtra Patel Seva Samaj

S P S S - Surat

"Jamnaba Vidhyarthi Bhavan", Maniben chowk, Valak Patiya Char Rasta, Kamrej Road., Surat

+91 99091 88222

spss.surat@gmail.com

READING LIBRARY REGISTRATION FORM

BASIC DETAILS

First Name *

Father Name*

Surname *

Sub Caste *

Gender *

Mobile Number*

E-mail *

Father Mobile Number*

Date of Birth *

Age *

Blood Group *

Permanent Address *

State *

City *

Pincode *

Native Home In Saurashtra/Address *

Village*

District*

Taluka*

Is Physically Challenged *

Absence of Parents*

Aadhar No *

Have You Pan No ? *

Pan No

Are you currently studying? *

Admission Base: *

Course Name*

College/School Name*

Passport Sized Photo (max: 500KB,JPG/PNG) *

Aadhar Card front (max: 500KB,PNG/JPG/PDF)*

Aadhar Card Back (max: 500KB,PNG/JPG/PDF) *

Leaving Certificate (max: 500KB,PNG/JPG/PDF) *

Light Bill (max: 500KB,PNG/JPG/PDF) *

Register!.. to study in Next Academic Year.