Student Registration

Registration form for New Student Admission

This Form will be used for new Students of enrollment

Step 1 of 5

Applicant's Full Name / आवेदक का पूरा नाम*
First Last
Enter User Id/उपयोगकर्ता आईडी दर्ज करें*

In case user id is taken by someone change the user id
Email / ई-मेल*
Phone / फ़ोन*
Facebook id / फेसबुक आईडी*

जिन छात्रों का फेसबुक अकाउंट नहीं , उनका फसबबक अकाउंट खोल दिया जाए और स्टूडेंट से https://www.facebook.com/rcsm1995/ पेज को लिखे तथा फ्रेंड आग्रह भेजा जाये।

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Student Registration ID / छात्र पंजीकरण आई.डी.
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Student Registration Number / छात्र पंजीकरण संख्या
Father's Name / पिता का नाम*

Entre Full Name of your Father Name as like in Certificate
Mother's Name / मां का नाम का नाम*

Entre Full Name of your Mother’s Name / मां का नाम का नाम
Gender / लिंग*
- Male / पुरुष
- Female / महिला
DOB/ जन्म तिथि*
DD slash MM slash YYYY

Enter Date of Birth Day
Address / पता*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code India
Select AEC (Study Centre)*
Mention 3 Choice of Study Centre / अध्ययन केंद्र के 3 विकल्प का उल्लेख करें*
Opt. No. Area (Village/Colony) City/Block District State Pin Code

Educational Qualification / शैक्षिक योग्यता*
SSC, Inter, Graduation & More Name of Board Year of passing % of passing

SSC, Inter, Graduate, PG
Select ID Proof / आईडी सबूत का चयन करें*
Entre ID Proof Details /आई.डी. सबूत विवरण**
Select Address Proof / पता प्रमाण का चयन करें*
Entre Adress Proof Details / पता सबूत विवरण*
Physically Challenged/ शारीरिक रूप से विकलांग*
Caste Category / जाति श्रेणी*
Father’s Occupation / पिता का व्यवसाय*
Mother’s Occupation / मां का व्यवसाय
What your are doing now / अब आप क्या कर रहे हैं ?*

Aadhar Card Number / आधार कार्ड संख्या*
Upload Photo / फोटो अपलोड*
Max. file size: 1 MB.
Upload Application Form / पूर्ण भरा आवेदन पत्र*
Max. file size: 1 MB.
Upload Full Filled Application Form with Signature / हस्ताक्षर के साथ पूर्ण भरा आवेदन पत्र
Upload Signature / हस्ताक्षर अपलोड*
Max. file size: 1 MB.
Upload Left Hand Thumb Impression / बांए हाथ के अंगूठे का निशान अपलोड
Max. file size: 1 MB.
Email of AEC you like to send copy of Registration*

Email on which you like to send the copy of Registration Details of Student Admission(Mention AEC Email ID)
Declaration / घोषणा*
- I , hereby declare that the particulars submitted by me in the Regestration cum Admission application form are true to the best of my knowledge and belief. I agree to abide by the rules and regulations of RCSM and also to the decision of RCSM regarding my admission for the examination. I have noted that, RCSM has the right to withhold my result even after my appearing in the examination in addition to any other action as may be deemed fit in the event of any of the statements/particulars made above being found incorrect. I have noted that, I might be required to start the study & appear in the study centre/examination at any other study centre/examination center not specified under study centre/examination center choice column . I further understand that, in the event of non-conduction /non-evaluation of my examination due to any reason whatsoever, I will not held RCSM responsible for any damages. मैं, इस प्रकार घोषणा करता हूं कि पंजीकरण सह प्रवेश आवेदन पत्र में मेरे द्वारा जमा किए गए विवरण मेरे ज्ञान और विश्वास के सर्वोत्तम हैं। मैं आरसीएसएम के नियमों और प्रवेश और परीक्षा के लिए प्रवेश के संबंध में आरसीएसएम के फैसले का पालन करने के लिए सहमत हूं। मैंने ध्यान दिया है कि आर.सी. एस.एम. को किसी भी अन्य कार्रवाई के अलावा परीक्षा में शामिल होने के बाद भी मेरा परिणाम रोकने का अधिकार है, जैसा कि गलत पाया गया है, ऊपर दिए गए किसी भी बयान / विवरण की स्थिति में फिट माना जा सकता है। मैंने ध्यान दिया है कि, मुझे अध्ययन शुरू करने और अध्ययन केंद्र / परीक्षा केंद्र में किसी भी अन्य अध्ययन केंद्र / परीक्षा केंद्र में अध्ययन केंद्र / परीक्षा केंद्र विकल्प कॉलम के तहत निर्दिष्ट नहीं होना चाहिए। मैं आगे समझता हूं कि, किसी भी कारण से मेरी परीक्षा के गैर-संचालन / गैर-मूल्यांकन की स्थिति में, मुझे किसी भी नुकसान के लिए आरसीएसएम जिम्मेदार नहीं ठहराया जाएगा ।

Entre Choice of Course with or without Learning Kit*
Entre Choice of Course with or without Learning Kit
Select Course for which you interested to Join*
Select Course Duration*
Select Course Duration
Select Batch ID*
Course Certification Month*

i.e : FEB-19 / MAR-19
Buy Course*
Quantity*
Please enter a number from 1 to 1.
Total
$0.00

Request an Empanelment of Centre

Please complete the form to for Request for Empanelment of your center. We will reply as soon as possible.

Step 1 of 3

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Applicant Enq Reg No
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Applicant Reg. ID
Name of Applicant*
First Last
Entre Your Gender*
- Male
- Female
DOB Applicant*
DD slash MM slash YYYY
Phone No. of Applicant*
Email of Applicant*
Facebook id of Owner
Other Social ID of Owner
Postal Address of First Owner*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Planning to Start or Running your institute*
Enter your Centre Name (if Proposed also)*
You're Applying as a*
New Startup / Running Centre / RCSM Lock/Incative Centre

Year of Association*

Day
Month
Year
Address of Centre
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Organization Type of Your Institute*
Your Institute/Centre (Rented/Own)*
Total Space of your Centre*
Space of Institute (L*W Size)*
Sl. No. Reception Area Lab Room (Size) Class Room (Size) Wating Hall (Size) Staff Room (Size) Others (Size) Total (Size)
Specify room area size in length x width
Entre Total No.'s of Employee Details*
No.'s Teaching Staff No.'s Non-Teaching Staff Total Staff
Centre Owner also teaches as Faculty/Instructor*
Owner Name Teach (Yes/No) Experience Modules teaches by you (i.e-tally, C, DCA , DTP)

If Centre Manager has interest in teaching please mention
Laptop/Desktop Details in Centre*
Laptop/Desktop Assembled/Company Make/Brand Processor Speed (MHz/GHz) Memory (GB) HDD (GB/TB) Wi-Fi (Yes/No) No.'s
List of Peripherals available in Centre (Printer/Camera/Wifi/Lan etc)*
Sl. No. Peripherals Name Make Description Qty (Present)
Available Internet Connection Speed*

Mention in Mbps/Kbps
Monthly walk in & Conversation ration (%) details of Institute
Sl. No. Total Walk in Enq/month Total Phone in Enq/month Others Total % Of Conversations/month
Courses demand of Institute by student
Sl. No. Course Name Demand (%)

Add up to 7 course and all in total % should be 100% only, Through which it will judged kind of course are in demand .
Last three Financial Year Student Enrolled in Institute
Financial Year Total Business No.'s of Student Total Profit/Loss (+/-) Approx Remarks

Financial Year (Present Year/Past 2 Years)
Promotional Budgets Yearly (Approx)
Select Promotional budget yearly
Institute Photo
Drop files here or

Max. file size: 1 MB, Max. files: 5.

Current Occupations*
Select Choice of Online Association Plan*
How fast you planning to Start/Association with us*
How you here about us*
Prefer mode to contact you*
Prefer time to Contact you (After)*

(i.e 08:00 am / 06:00 pm)
Entre your one or more choice*
- Select All
- Ready to understand the Business Proposal
- Ready to Visit Nearest office to Understand
- Not intrested
Share any query related to association
Product Name
Quantity

Registration form for New Student Admission

Step 1 of 5

Request an Empanelment of Centre

Step 1 of 3

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Opt. No.	Area (Village/Colony)	City/Block	District	State	Pin Code

SSC, Inter, Graduation & More	Name of Board	Year of passing	% of passing

Owner Name	Teach (Yes/No)	Experience	Modules teaches by you (i.e-tally, C, DCA , DTP)

Laptop/Desktop	Assembled/Company	Make/Brand	Processor Speed (MHz/GHz)	Memory (GB)	HDD (GB/TB)	Wi-Fi (Yes/No)	No.'s