Student Admission + Internet Usage Survey Form

Please fill out this form to apply for admission to CodingGita University and help us understand your internet usage and skills.

Personal Information

Full Name: Father’s Name: Mother’s Name: Email Address: Phone Number: Enter a valid 10-digit mobile number. Date of Birth:

Gender

Male Female Other

Nationality: Upload Photo (JPG/PNG only):

Highest Qualification: Stream: Percentage/CGPA: Year of Passing:

Subjects Studied

Upload Certificates: Preferred Course:

Admission Category

Internet Access? Yes No

Devices Used Daily Laptop Mobile Tablet Desktop

Average Daily Usage: Preferred Study Time: Drag to select GB usage: Favorite Social Platform:

Why do you want to join CodingGita? How has the Internet helped your education?

Would you recommend CodingGita to friends? Yes No

I hereby declare that the information provided above is true to the best of my knowledge. Upload Signature (JPG/PNG): Date of Submission: