CodingGita University – Student Admission + Internet Usage Survey
Please fill out this form carefully. All fields marked with * are mandatory.
Section 1: Personal Information
Full Name *
Father's Name
Mother's Name
Email Address *
Phone Number *
Enter a valid 10-digit mobile number (6000000000–9999999999).
Date of Birth
Gender
Male
Female
Other
Nationality
Indian
NRI
Other
Upload Photo (JPG/PNG only)
Section 2: Academic Details
Highest Qualification
High School
Bachelors
Masters
PhD
Stream
Science
Commerce
Arts
Other
Percentage/CGPA *
Year of Passing
Subjects Studied
Physics
Chemistry
Math
Biology
CS
English
Others
Upload Certificates
Preferred Course
MERN Stack
DSA Bootcamp
AI/ML
Web Development
Cloud Computing
Admission Category
General
SC
ST
OBC
EWS
Section 3: Internet Usage & Skills Survey
Do you have Internet Access?
Yes
No
Devices used daily
Laptop
Mobile
Tablet
Desktop
Average Daily Usage
Less than 1 hour
1–3 hours
3–6 hours
6+ hours
Preferred Study Time
Weekly Data Usage (GB)
Drag to select GB usage
Favorite Social Platform
Skills
HTML
CSS
JS
React
Node.js
MongoDB
Git
Other
Upload Internet Speed Test Screenshot
Pick your favorite color
How satisfied are you with your internet speed? (1–10)
Section 4: Declaration & Final Submission
Why do you want to join CodingGita? *
How has the Internet helped your education?
Would you recommend CodingGita to friends?
Yes
No
I hereby declare that the information provided above is true to the best of my knowledge.
Upload Signature (JPG/PNG)
Date of Submission