Student Registration Form

विद्यार्थी दर्ता फारम

Fill in this form to register with PEC Consultancy. Your counsellor will review it and set up your student portal, where you can track your application, visa and documents.

APersonal detailsव्यक्तिगत विवरण

First name *

Middle name

Last name *

Gender

MaleFemaleOther

Date of birth (AD)

Date of birth (BS)

Mobile / WhatsApp *

Alternative phone

Nationality

Email (used for your student portal login) *

Marital status

SingleMarried

Permanent address (Tole, Ward, Municipality)

District

Province

Current address (if different)

City

Citizenship no.

Passport no.

Passport issue date

Passport expiry date

BParent / guardian / sponsorअभिभावक / प्रायोजक

Father's name

Occupation

Phone

Mother's name

Occupation

Phone

Sponsor name (if different)

Relation to you

Phone

CAcademic qualificationsशैक्षिक योग्यता

Fill the levels you have completed

	School / college	Board / university	Passed year	GPA / %	Major / stream
SEE / SLC
+2 / A-Level
Diploma
Bachelor
Master

EEnglish / language testsभाषा परीक्षा

Scores (leave blank if not taken)

	Overall	Listening	Reading	Writing	Speaking	Test date
IELTS
PTE
TOEFL / Duolingo
JLPT / NAT / TOPIK

Not taken yet — I want to join a PEC language class

GWork experience & travel historyकार्य अनुभव र यात्रा

Work experience

	Organisation	Position	From	To
#1
#2

Ever refused a visa?

NoYes

Travelled abroad before?

NoYes

If yes, which country, year and reason

IDeclarationघोषणा

I confirm the information is true and complete. False information or documents may lead to refusal of my application or visa. I allow PEC Consultancy to keep my details, share them with universities and authorities for my application, and contact me by phone, WhatsApp, SMS and email. *

Type your full name as signature *

Parent / guardian name (optional)

Fields marked * are required. You will get a reference number and a printable copy.