Offline Library | Student Signup

SINGUP FORM

Enter First Name

Enter Middle Name

Enter Last Name

Branch Name : Akota Manjalpur

Enter Date of Birth(dd-mm-yyyy Format)

Gender Female Male

Address 1

Address 2

Post Code

City

Mobile Number

Enter Email

Identity Proof

Qualification

Course Pursuing

Unversity

Purpose to enroll Offline

I AGREE TO PAY FEES AS UNDER:

Registration Fees: Rs.100

Membership(dd-mm-yyyy - dd-mm-yyyy format)

Shift Timing : 7a.m to 3p.m 3p.m to 11p.m 7a.m to 11p.m Other

Verification code :

I have applied for membership and agree to abide by the Rules & Regulations of library and restriction if any decided bt manegment.