IFSMA-INDUSTRIAL FIRE & SAFETY MANAGEMENT ACADEMY

Personal Details

Please provide your personal details

Student Name*

Father's Name*

Mother's Name*

Date of Birth*

Gender*

Category*

Id Proof Type* :

Adharcard Front* :

Adharcard Back* :

Are you employed?* :

Employer Name* :

Designation* :

Mobile Number*

Mail Id*

Father's Number

Mother's Number

Current Address

State*

City*

Pincode*

Nationality*

Country*

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Qualification Details

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Exam*

Secondary

Sr. Secondary

Graduation

Post Graduation

Other

L.C.

Exam*

Secondary

Sr. Secondary

Graduation

Post Graduation

Other

L.C.

Year of Passing*

Exam*

Secondary

Sr. Secondary

Graduation

Post Graduation

Other

L.C.

Board/University*

Exam*

Secondary

Sr. Secondary

Graduation

Post Graduation

Other

L.C.

Total Percentage(%)*

Exam*

Secondary

Sr. Secondary

Graduation

Post Graduation

Other

L.C.

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Course/Programme Details

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Course Type* :

Faculty* :

Course* :

Month Session* :

Duration :

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