ONLINE ENQUIRY FORM
ENQUIRY INFORMATION
Enquiry Date
Time
ENQUIRY TYPE*
ONLINE
ENQUIRY SOURCE*
INTERNET
If OTHER Specify
STREAM*
--SELECT--
AGRICULTURE SCIENCE
APPLIED ARTS
ARCHITECTURE & PLANNING
BASIC & APPLIED SCIENCES
COMMERCE
COMMUNICATION
EDUCATION
ENGINEERING
FASHION
FASHION & DESIGN
FINE ARTS
FOOD & NUTRITION
HOSPITAL & HEALTH MANAGEMENT
HOSPITALITY
HUMANITIES
HUMANITIES & SOCIAL SCIENCE
INF. TECH /COMP. SCI.
JOURNALISM & MASS COM.
LAW
MANAGEMENT
MEDIA, FILM & ENTERTAINMENT
MEDICAL & APPLIED SCIENCE
NURSING
PHARMACY
RESEARCH
SCIENCE
SECONDARY
SENIOR SECONDARY
TOUR & TRAVEL
YOGA
PROGRAM MODE*
REGULAR
DISTANCE
UNIVERSITY*
--SELECT--
AMITY
CCS MEERUT
CH. RANBIR SINGH
G.D. GOENKA
GURUGRAM UNIVERSITY
HARYANA BOARD
JAMIA MILLIA ISLAMIA
KASHMIR
KURUKSHETRA
MAHARSHI DAYANAND
NIOS
SUBHARTI
COURSE*
--SELECT--
IF OTHER
FOLLOWED BY *
KANCHAN SHARMA
STATUS
WIP
NEXT DATE
UNIVERSITY SUGGESTED
--SELECT--
AMITY
CCS MEERUT
CH. RANBIR SINGH
G.D. GOENKA
GURUGRAM UNIVERSITY
HARYANA BOARD
JAMIA MILLIA ISLAMIA
KASHMIR
KURUKSHETRA
MAHARSHI DAYANAND
NIOS
SUBHARTI
COURSE SUGGESTED
--SELECT--
PERSONAL INFORMATION
NAME*
LAST NAME
DOB
MOBILE*
WHATS APP NO.
EMAIL*
Address
City
Pin
State
--Select--
Andra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Madya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telagana
Tripura
Uttaranchal
Uttar Pradesh
West Bengal
Andaman and Nicobar Islands
Chandigarh
Dadar and Nagar Haveli
Daman and Diu
Delhi
Lakshadeep
Pondicherry
Country
Employment Status
--Select--
WORKING
NON WORKING
Company
Position
Father's Name
Father's Mobile
Mother's Name
Mother's Mobile
LAND LINE
How does he/she know about NIPS?
--Select--
Newspaper
Student
Internet
Cable
Hoarding
Main Board
Poster
Leaflet
Other
Specify the Details
ENQUIRY MESSAGE*
Academic Qualification
Name of the Exam
Board/University
School/College
Stream/Subject
Year of Passing
MARKS OBTAINED
TOTAL MARKS
% of Marks
