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MO Test form

Name of the Student: *

Date of Birth:

Phone *

Email *

Course Category: *

Select specialization: *

Mother's name: *

Father's/Guardian's name: *

Current address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Is your current address different from your permanent address?

Yes
No

Permanent address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Select your designated counselor:

Gender:

Male
Female
Other

Have you gone through video verification?:

Yes
No

Are you a referred student?:

Yes
No

Enter the name of your contact:

Do you require video conference with University Counselor:

Yes
No

Have you submitted all academic documents at EduAcharya?

Yes
No

Acknowledgement: *

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I agree the information I have provided here is true and genuine.

EduAcharya

B-Tech Credit Transfer, Online degree courses

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