CodingGita University Admission + Internet Usage Survey

Section 1: Personal Information Full Name:

Father's Name:

Mother's Name:

Email Address:

Phone Number: Enter a valid 10-digit Indian mobile number

Date of Birth:

Gender Male Female Other

Nationality:

Upload Photo (JPG/PNG only):

Section 2: Academic Details Highest Qualification:

Stream:

Percentage/CGPA:

Year of Passing:

Subjects Studied Physics Chemistry Math Biology CS English Others

Upload Certificates:

Preferred Course:

Admission Category General SC ST OBC EWS

Section 3: Internet Usage & Skills Survey

Internet Access? Yes No

Devices Used Daily Laptop Mobile Tablet Desktop

Average Daily Usage:

Preferred Study Time:

Weekly Data Usage (GB): Drag to select GB usage

Favorite Social Platform:

Skills HTML CSS JS React

Section 4: 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

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

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Date of Submission: