Madin i land
Home
About
Service
Gallery
Contact
Call Us: +91 9946777178 / +91 7736345313
Please enable JavaScript in your browser to complete this form.
1
Step 1
2
Step 2
3
Step 3
Name
*
As mentioned In Date of birth certificate or SSLC
Age
*
Date of Birth
*
Nationality
*
Indian
Other
Gender
*
Male
Female
Religion
*
Islam
Other
Residential Status
*
Kerala Resident
Other
Email
*
Mobile Number for SMS Notifications
*
General categorization
*
General
Other
Name of Father
*
Education of Father
*
profession/Occupation of Father
*
Name of Mother
*
Education of Mother
*
profession/Occupation of Mother
*
Next
Permanent Address
*
House name/Flat No
*
Place
*
Post Office
*
PIN Code
*
Dropdown
*
Kerala
Other
City/Nearest City
*
Residence Phone Number with STD Code
*
Father's Mobile Number
*
Mother's Mobile Number
*
Any other Guardian Number
*
communication address
*
Permanent address and communication address are same
Next
Name of school attended last year
*
Place of school
*
Class attended last year
*
4th STD
Other
Medium of Instruction in your previous school
*
Name of Madrassa attended in previous year
*
Year of leaving school
*
Last class attended in madrassa
*
4th STD
Other
Message
Submit
Shopping Basket
