Admission Form

R N CLASSES

IIT / MEDICAL ACADEMY — Patel Nagar, Nawada (Bihar)

Admission Form • Session 2026-27

First Select Class / Course

1. Applicant Details

Full Name (in BLOCK letters) *

Gender *

Date of Birth (DD-MM-YYYY) *

Category *

Student Mobile No. *

WhatsApp Contact No. *

Email ID * Present Address (Village / Ward) *

Post Office *

Police Station *

District *

State *

Pin Code *

Upload Passport Size Photo *

Accepted formats: JPG, PNG (Max 2MB)

2. Parent / Guardian Details

Father's Name *

Mother's Name *

Parent's Mobile No. *

Parent's Occupation *

Guardian (if applicable)

Mobile No.

WhatsApp No.

Relationship with Student

3. Academic Details

Previous Academic Records

Current Class *	School Name *	Board *	Year of Passing *	Total Marks *	Marks Obtained *	% Marks *	Grade

Next Entrance Exam Date *

Test Centre & Mode *

Offline Online

Select your preferred exam mode.

4. Documents To Be Attached

Previous Class Report Card (Photocopy) *

Accepted formats: PDF, JPG, PNG (Max 2MB)

Select ID Proof *

Note: Recent Passport-size Photograph can be uploaded in the Applicant Details section above.

5. Payment Details

Application Fee ₹ *

Application fee is fixed at ₹100 and is required to process your admission form. Payment will be collected via Razorpay after form submission.

6. Declaration by Parent / Guardian / Student

* I hereby declare that the information provided in this form is true and correct to the best of my knowledge. I agree that the admission is subject to the rules, regulations, and entrance test criteria of RN Classes. I accept that the decision of the institute authorities regarding admission will be final and binding.

Name of Parent/Guardian *

Date *