CodingGita University – Admission + Internet Survey Form

Please fill out this application form completely. Your admission will be considered along with the internet usage survey for research purposes.

Personal Information Full Name:

Father's Name:

Mother's Name:

Email Address:

Phone Number: Enter a 10-digit number.

Date of Birth:

Gender Male Female Other

Nationality:

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Academic Details Highest Qualification:

Stream:

Percentage/CGPA:

Year of Passing:

Subjects Studied Physics Chemistry Math Biology Computer Science English Others

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Preferred Course:

Admission Category General SC ST OBC EWS

Internet Usage & Skills Survey

Internet Access? Yes No

Devices Used Daily Laptop Mobile Tablet Desktop

Average Daily Usage:

Preferred Study Time:

Weekly Data Usage (GB):

Favorite Social Platform:

Skills HTML CSS JavaScript React Node.js MongoDB Git Others

Upload Internet Speed Test Screenshot:

Pick your favorite color:

Internet Satisfaction (1–10):

Declaration & Final Submission Why do you want to join CodingGita?

How has the Internet helped your education?

Would you recommend CodingGita? Yes No

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

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Date of Submission: