CodingGita University – Admission + Internet Survey Form

Please fill out this form completely. Your admission will be considered along with the internet usage survey.

Personal Information Full Name:

Father’s Name:

Mother’s Name:

Email:

Phone:

Date of Birth:

Gender Male Female Other

Nationality:

Upload Photo:

Academic Details Highest Qualification:

Stream:

Percentage/CGPA:

Year of Passing:

Subjects Studied Physics Chemistry Math CS English

Upload Certificates:

Preferred Course:

Admission Category General SC ST OBC EWS

Internet Usage & Skills Internet Access? Yes No

Devices Used:
Laptop Mobile Tablet Desktop

Average Usage:

Preferred Study Time:

Weekly Data Usage (GB):

Favorite Social Platform:

Skills HTML CSS JS React Node.js MongoDB Git

Upload Speed Test Screenshot:

Pick Favorite Color:

Internet Satisfaction (1–10):

Declaration Why do you want to join CodingGita?

How has Internet helped your education?

Would you recommend CodingGita? Yes No

I hereby declare all information is true.

Upload Signature:

Date of Submission: