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.

Section 1: Personal Information

Full Name

Father's Name

Mother's Name

Email Address

Phone Number (10 digits)

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 (select any month in that year)

Subjects Studied (choose all that apply)

Physics

Chemistry

Math

Biology

Computer Science

English

Others

Upload Certificates (PDF/JPG/PNG, multiple)

Preferred Course

Admission Category

General

OBC

EWS

Section 3: Internet Usage & Skills Survey

Do you have Internet access?

Yes

Devices used daily (select all that apply)

Laptop

Mobile

Tablet

Desktop

Average Daily Usage

Preferred Study Time

Drag to select GB usage (1-100 GB)

Favorite Social Platform

Skills (select all that apply)

HTML

CSS

React

Node.js

MongoDB

Git

Others

Upload Internet Speed Test Screenshot

Pick your favorite color

How satisfied are you with your internet speed? (1-10)

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

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

Upload Signature (JPG/PNG)

Date of Submission