Mahamana Shikshan Sansthan

(Bhaorao Deoras Seva Nyas)

Admission Form

[For IIT (JEE)/NEET(PMT) Preparation]

Important Instructions For Apply Admission Form Online Click Here To Read

Only students appeared in current year High School Examination need to apply

Select Target Course*

Registration Date*

1. Name*

2. Date of Birth*

3. Father's Name*

4. Mother's Name*

5. Gender*

5. Category*

6. Contact Number*

7. Email Address*

8. Select State*

9. Permanent Address*

9(a). Select District*

9(b)Village/Mohalla/Tola *

9(c)Post/Town *

9(d). Pincode*

10. Annual Family Income (From all sources)*

11. Number Of Sibling(s)*

12.(a) High School Subject & Marks*

Maths & Science %

Marks Obtained (प्राप्तांक)

Total Marks(पूर्णांक)

Total %

Passing Year * *Please select Passing Year

Board * *Please select Board

School Name * *Please enter School Name

13. Reference By Two Respected Persons Of The Society:

Name

Designation

Mobile

Name

Designation

Mobile

14. Candidate Photo *

15. Candidate Signature *

Decleration by Parent

I do hereby declare that all the information furnished above is true and in case any information is found to be false at any stage, the candidature/admission may be cancelled.
I do hereby declare that I have read & understood the important instruction regarding filling the form & eligbility.

District/Place*
Date:*

Parent Signature*

Email id:query.mmss@gmail.com Contact Number: 0522-4623028