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Office no F21, first floor , Haware Centurion Complex Sector 19a, near seawoods, Nerul (E, Navi Mumbai, Maharashtra 400706

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+91 8691025921

+91 9833761826

info@samiinfotech.com

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CONTACT FOR AFFLIATION

+91 91375 43409
+91 9833761826

APPLICATION FORM FOR AFFILIATION

Information About Institution

District Coordinator Code

Affiliation Type & Fee(Required)

Institute Name(Required)

Institute Address(Required)

City(Required)

District(Required)

Pin(Required)

State(Required)

Country(Required)

Phone(Required)

Email(Required)

Information About the Chief Executive/Principal/Director of the Institute

Name(Required)

Photo(Required)

Max. file size: 512 MB.

Designation/Position(Required)

Education Qualifiation(Required)

Professional Experience(Required)

D.O.B(Required)

Address of Head(Required)

City(Required)

District(Required)

Pin(Required)

State(Required)

Country(Required)

Phone(Required)

Email(Required)

Infrastructure Facility

Staff Room(Required)

NO.OF ROOMS

SEATING CAPACITY

TOTAL AREA (Sq.Ft.)

Class Room(Required)

NO.OF ROOMS

SEATING CAPACITY

TOTAL AREA (Sq.Ft.)

Computer Lab(Required)

NO.OF ROOMS

SEATING CAPACITY

TOTAL AREA (Sq.Ft.)

Reception(Required)

NO.OF ROOMS

SEATING CAPACITY

TOTAL AREA (Sq.Ft.)

Toilets(Required)

NO.OF ROOMS

SEATING CAPACITY

TOTAL AREA (Sq.Ft.)

Any Other(Required)

NO.OF ROOMS

SEATING CAPACITY

TOTAL AREA (Sq.Ft.)

Payment Method(Required)

Demand Draft (DD)

Online Payment