Full Name
Father’s Name / Guardian’s Name
Date of Birth
Gender MaleFemaleOther
CNIC / B-Form / Student ID
Email Address
Contact Number (Student)
Contact Number (Parent/Guardian)
Address
City
Current Grade / Class
School / Institution Name
Course Name
Preferred Batch MorningEveningWeekend
Mode of Learning OnlineOn-Campus
Have you attended any STEM program before? YesNo
Emergency Contact Name
Relationship
Emergency Contact Number
I, the parent/guardian of the student, hereby give consent for my child to register and participate in the STEM Course.
I declare that the information provided is true and correct to the best of my knowledge.
