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Application Form for one year Diploma in Dance and Music Courses
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Name of the Applicant
*
Date of Birth
*
Age
*
Password
*
Confirm Password
*
Gender
*
Choose
Male
Female
Phone Number
*
Email Id(Username)
*
Address for communication
*
Details of Parent/ Guardian
Courses
*
Select the Course
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Courses Applied
*
Emergency Contact 1
Name
*
Relationship
*
Contact
*
Emergency Contact 2
Name
Relationship
Contact
Total Amount Payable(Including 18% GST & 1% cess):
₹
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