Target Institute : Entrance Exam Preparation Center

All * marks are mandatory

-- Candidate Details --

Course Applied for ^*

Candidate Name ^*

Father Name ^*

Mother Name ^*

-- Address Details --

Village ^*

Post Office ^*

State ^*

District ^*

Pincode ^*

Email ^*

Mobile No. ^*

-- Please Upload Following Documents --

**Document should be in jpg or pdf files
**Maximum Size of file is 512kb

Photo of Candidate: ^*
Id Proof: Aadhar Card(Font Side): ^*
Id Proof: Aadhar Card(Back Side): ^*

-- Payment Details --

**Application fees : Rs. 100/-

Name of Bank	Bank of Maharashtra
Beneficiary Name	Target Institute
IFSC Code	BIO11544
Account No.	0000000000

Mode of Payment by ^*

Amount Paid ^*

Payment Transaction No. ^*

No Refund :- Fee once paid shall not he refunded in any circumstances.

I hereby declare that, all in information provided by me are true to the best of my knowledge and nothing has been concealed therein. Brilliant Institute may reject my application at any point of time, if the information provided by me found not true.