Name of the Student *

Legal first and last name

First Name

Last Name

Applicable messaging app to the above number

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Whats App

FB Messanger

Telegram

Signal

Viber

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IMO

Others

Have you taken any of our diagnostic tests? *

Select one option

Yes

No

Not sure

Does any of the groups apply to you? *

You can select one or more options. However, only one of the waivers (maximum) will apply.

None

Women

Refugee

Economically Weaker Section

Victim of an atrocity

Any groups under national affirmative action

Did you speak to anyone from our team? *

Yes

No