CodingGita University – Admission + Internet Survey Form

Please fill out this application form completely. Your admission will be considered along with the internet usage survey for research purposes.

Personal information

Full Name:

Father’s Name:

mother’s Name:

Email:

Phone Number:

Date of Birth:

Gender : Male Female Other

Nationality:

Upload Photo(JPG/PNG only) :

Academic Details

Highest Qualification

Stream :

Percentage/CGPA :

Year of Passing:

subject Studied Physics Chemistry Maths English Biology CS Other

Certificate :

Preffered Course :

Admission Category : General EWS ST SC OBC

Internet Usage & Skills Survey

Internet Access? : Yes No

Devices Used Daily : Laptop Mobile Tablet Destop

Average Daily Usage:

Preferred Study Time

Drag to select GB usage :

Favorite Social Platform

Skill : HTML CSS JS Nodes.js MongoDB Git REACT Others

Upload Internet Speed Test Screenshot :

Favorite Color :

Internet Satisfaction :

Declaration & Final Submission

Declaration

Why do you want to join CodingGita?

How has the Internet helped your education?

Would you recommend CodingGita to friends? : Yes No

I hereby declare that the information provided above is true to the best of my knowledge.

Upload Signature :

Date of Submission :