Register
 
  Sub. : Application for admission in the Course :
1. Photo of Applicant (Upload JPG/JPEG File) :
2. Name of the Applicant (Block Letters) : *
3. Father's Name : *
4. Permanent Home Address :
5. Address for Communication : *
  City : *
  State : *
  Zip Code :
  Country : *
  Phone No. (O) :
  Phone No. (R) : *
  E-mail : *
  Fax :
6. Date of Birth (DD-MM-YYYY) : *
7. Nationality : *
  Sex : Male Female
8. Qualification in Ayu : *
9. Passport No.(for foreigners students only) :
  Issued From :
  Expected date of arrival in India (DD-MM-YYYY) :
  Valid Upto :
10. Address in India (If in India) : *
  Phone No. (O) :
  Phone No. (R) :
11. Academic Qualifications : *
12. Medical Qualifications : *
13. Experience in Practice
: *
 
 
 
 
 
Send DD in beneficiary to GAU A/C USCE
Dr. Varsha R. Solanki, Program Director,
University School of Continuing Education in Ayu,
Chankya Bhavan, Gujarat Ayu University, Jamnagar, Gujarat (India).
Pin - 361008
Contact for more details:
Phone No. (O): 0288-2664867
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