STUDENT ENQUIRY FORM

Personal Information

First Name
Ayush

Middle Name

Last Name

Date Of Birth
December 19, 2002

Country Of Birth
India

Citizenship

Gender
Male

Marital Status
Single

First Language
Hindi

Mailing Address
ayush.dta@gmail.com

House Address
Datia

City
Datia

Country
India

Telephone
9039968260

Student Email
ayush.dta@gmail.com

Passport Number

Passport Expiry Date

Emergency Contact Name
()

Emergency Contact Telephone

Emergency Contact Email

Program Choice

First Program Choice

Start Date

Second Choice

Start Date

Educational Background

Name of School Attended
Lord Krishna Public School

School Attended
Lord Krishna Public School

Level
High School

From(mm/dd/yy)
01/09/2008

To(mm/dd/yy)
04/22/21

Certificate

Grade Avg./Class

Lang.of Instruction

School Address

Country of Education

Was your education interrupted fro longer than 6 months? No.

Have you been refused a visa from Canada, the USA, The United Kingdom, Australia, or New Zealand? No. .

Do you have a study permit? Yes

Services Requested for: Guiding and counselling to choose a course of study., Assisting in completing institution (selected) application form., Facilitating and coordinating with institutions until final admission., Assisting to find suitable accommodation., Editing of Letter of Intent/Statement of purpose.

Are you ready to make payment now: No

I agree that Edtex Education can use my information to apply for school/educational Institution.

Official Use Only

Final Institution of Interest

Commencement of Studies

Application Fee Status
unpaid

Payment date