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:
DOB:

Gender: Male Female Other

Nationality:
Upload Passport-size Photo:

[Academic Details] Highest Qualification:
Stream:
Percentage/CGPA:
Year of Passing:
Subjects Studied: Physics Math CS English
Upload Certificates:
Preferred Course:
Admission Category: General SC ST OBC EWS

[Internet Usage & Skills Survey] Internet Access? Yes No
Devices Used: Laptop Mobile Tablet Desktop
Average Daily Usage:
Preferred Study Time:
Weekly Data Usage:
Favorite Social Platform:
Skills: HTMl CSS JS React Node.js MongoDB GitHub Others
Upload Internet Speed Test Screenshot:
Favorite Color: Pick your favorite color
Internet Satisfaction:

[Declaration & Final Submission] Why do you want to join CodingGita?

How has the Internet helped your education?

Would you recommend CodingGita to friends? Yes No
Declaration Checkbox: “I hereby declare that the information provided above is true to the best of my knowledge.”
Upload Signature: Upload Signature (JPG/PNG)
Date of Submission:
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