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 Fieldset Full Name:

Father's Name:

Mother's Name:

Email:

Phone Number:

Date of Birth:

Gender: Male Female Other

Nationality:

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Academic Details Fieldset Highest qualification

Stream:

Percentage/CGPA:

Year of Passing:

Subjects Studies: Mathematics Physics English Computer Science

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Preferred Courses:

Admission Category: General SC ST OBC EWS

Internet Usage & Skills Fieldset Internet Access: Yes No

Devices Used: Laptop Mobile Tablet Desktop

Average Usage:

Preferred Study Time:

Weekly Data Usage: 50 GB

Favorite social platform:

Skills: HTML CSS React Node.js MongoDB Git

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Favorite Color:

Internet Satisfaction: 5/10

Declaration Fieldset Why join CodingGita?

How has Internet helped your education?

Recommend CodingGita? Yes No

I hereby declare all information is true.

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Date of Submission: