LASAK EDU

OPEN FOR ALL LEARNING NEEDS

Student Admission Form

Full Name *

Date of Birth *

Gender *

Phone Number *

Email Address *

Residential Address *

Referrer 1 Name *

Referrer 1 Email *

Referrer 1 Contact *

Referrer 1 Occupation *

Referrer 2

Referrer 2 Name *

Referrer 2 Email *

Referrer 2 Contact *

Referrer 2 Occupation *

College / Company Name

Previous School/College

Previous Marks/CGPA

Course Start Date *

Course End Date *

Select Course *

Apply for Academic Scholarship

Upload candidate files (PDF/JPG, Max 500KB per file).

Passport Photo *

Drag or Browse Photo

Signature Proof *

Drag or Browse Signature

ID Proof (Aadhar/PAN) *

Drag or Browse ID Document

10th Marksheet *

Drag or Browse 10th marksheet

12th Marksheet *

Drag or Browse 12th marksheet

UG Certificate (Optional)

Drag or Browse UG Certificate

Payment Mode *

Payment Frequency *

Installments Count *

I agree to the Terms and Conditions of Lasak Techno Institute.