Student Admission Form

Form No:

Date:

Personal Information

Full Name *

Father's Name *

PASSPORT SIZE
PHOTO
(1.5" × 1.5")

Date of Birth *

Gender *

Nationality

CNIC / B-Form No. *

Religion

Permanent Address *

City *

Province

Postal Code

Contact Details

Mobile Number *

WhatsApp Number

Email Address

Guardian / Parent Name *

Guardian Contact Number *

Educational Background

Highest Qualification *

Board / University

Passing Year

Course Selection

IT Fundamentals & Digital Skills

IT Basics

Professional Graphic Design

Creative

Full Stack Web Developer

Development

AI/ML & Data Engineering

Future Tech

Preferred Batch

Expected Start Date

Lead Source

I, the undersigned, hereby declare that all the information provided in this form is true, accurate, and complete to the best of my knowledge. I agree to abide by the rules, regulations, code of conduct, and academic policies of JSA Training Institute. I understand that any misrepresentation of information may result in cancellation of my admission without refund of fees paid.

Student Signature

Guardian Signature

Institute Authority

For Office Use Only — Official Record

Student ID

Batch Code

Status

Sign (Staff)