Student Onboarding Form Section-1 : Contact Information Basic contact information of student First Name * Last Name * Mobile No * WhatsApp Number (If it same as mobile number, mentioned it once again) * Email ID * Permanent Address * Home State * -Select- Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Goa Gujarat Haryana Himachal Pradesh Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal Permanent Address PIN Code * Parent Name (For Emergency Contact) * Parent Phone Number (For Emergency Contact) * Upload your photo (With close-up to your face, for identification purpose) * Your Social Media Profile ID (Instagram) - For internal reference * Your Social Media Profile Link (LinkedIn) - For internal reference * Next Academic Qualifications Student Academic Qualifications Class X Score (% or CGPA) * Class XII Score (% or CGPA) * BE / BTech Score (% or CGPA) * BE / BTech Branch * BE / BTech Year-Of-Passout (YYYY) * College State * -- Select State -- Andaman And Nicobar Island Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli and Daman and Diu Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karanataka Kerala Ladakh Lakshadweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland New Delhi Odisha Puducherry Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal Other BE / BTech College Name * BE / BTech College Location (City) * ME / MTech Score (If Applicable, Otherwise leave it blank) ME / MTech Branch (If Applicable, Otherwise leave it blank) ME / MTech Year-Of-Passout (If Applicable, Otherwise leave it blank) ME / MTech College Name (If Applicable, Otherwise leave it blank) Previous Next How did you come to know about Emertxe? Choose the below options -Select- Google Website Friends Webinar / Workshop Social Media (Instagram/Facebook/LinkedIn) Others Previous