Maharaja Agrasen International College

Counseling Form For : Session 2024-2025

For More Enquiry
8770197498,9893242088 9981373937,8770380094

Academic details
Enquiry No : Visitor Date :
     
Course : * Branch : Semester / Year
 
Is Visited ??      


Personal details
Max. 50 characters
     
Blood Group
   
Place of Birth Religion Student Aadhar No.* Student E-mail


Contact details
Local Address:
Student Mobile No.* Parents Mobile No* LandLine No. Local Address *
Local Resident of Raipur
   
Pin Code State District
Permanent Address:
Student Mobile No.* Parents Mobile No* LandLine No. Permanent Address *
   
Pin Code State * District


Family Background
Relation Name Profession Office Address Phone/Mob. No.
Father :
Mother :
Brother :
Sister :
Local Guardian :



Qualifications Acquired
Class/Degree Name of Board/University Subject Year of Passing Percentage
High School
Class X :
Higher Secondary
Class XII :
UG Degree :
PG Degree :
Others :



Other details
Ambition of Life: Extra Curricular Activities interested in: How do you come to know about MAIC? Are you domicile of Chhattisgarh?
MAIC Band   Rover & Ranger  
Sports   Other Activities
News Paper   Friends or Relatives  
Other Student   Other
Yes   No


Undertaking