Date
Have You Contacted Megamind Previously ?
Yes
No
If Yes
PERSONAL INFORMATION
First Name
*
Last Name
Date of Birth
Marital Status
select
Single
married
Passport :
Yes
No
Mobile Number
*
Emial ID (Block Letters)
*
Residence Number
PROGRAM INTERESTED IN
Course Name
Level :
Masters
Bachelors
Diploma
PG Diploma
Intake Month & Year
Preferred Country :
Canada
France
Germany
Ireland
New Zealand
UK
STUDENT QUALIFICATION
Level
Year of Passing
Board/University
Grade (% age or CGPA etc)
Marks Obtained in English
10
th
12
th
UG
PG
EMPLOYMENT
Work Experience (Year)
Designation
Organization
HOW DID YOU HEARD ABOUT MEGAMIND?
Social Media
Megamind Website
Flyers/ Posters/ Banners
Direct Walk-in
Other
Reference
REMARKS (FOR COUNSELLOR USE ONLY)
Counsellor Name
Submit
