Admission Form - CROWNEDGE NEET ACADEMY

Student Admission Form

Complete the details to start your journey with CrownnEdge NEET Academy

CrownnEdge Scholarship Cum Admission Test 2026

Ghatakpukur,Near Newtown, South 24 Parganas,743502, India

Student Details

Full Name *

Father's Name *

Mother's Name *

Religion *

Date of Birth (DD/MM/YYYY) *

Gender *

Male

Female

Other

Nationality *

Phone *

Email *

Category *

Aadhar Card Number * Enter your 12-digit Aadhar number

Course & Class Choice

Applied For Class *

Course Programme *

2 Years Programme (From Class XI)

1 Year Programme (Repeaters Batch)

Educational Background

Previous School Name *

Previous School Address *

Father's Details

Qualification *

Occupation *

Monthly Income *

Mother's Details

Qualification *

Occupation *

Monthly Income *

Permanent Address

Village *

Post Office (P.O) *

Police Station (P.S) *

District *

PIN Code *

State *

Test Centre

Test Centre *

Declaration

I hereby declare that the above information is true to the best of my knowledge and belief.

Place *

Date

Student Photo *

Click to upload student photo

JPG or PNG, max 2MB