REGISTRATION FORM

Name
Sex:Male

     Female 

Qualification:

Diploma

Graduate

Post Graduate

Ph.D

Other

College Address:





H.O.D Name & Mobile No: Telephone Email

COURSE APPLIED FOR:

Short Term Basic

Short Term advanced

Monthly Course(Sterm/Lterm)

One Year

Summer Training

Project Work

DURATION OF THE COURSE:

(Mention the week/ Month opted for with dates)
Accommodation assistance required:Yes No

please find attached Demand Draft Nofor Rs in favor of Syamala Srinivasa Life Sciences Pvt.Ltd,payable at Hyderabad.

Source of our Information:
Website
Paper advertisement
campaigning

email-Reference