SRCEPG
Shri Ram Centre For Excellence & Personal Growth
Email *
Name *
Date of Birth *
MM
/
DD
/
YYYY
Your Age *
Your Qualification *
Percentage in class tenth *
Percentage in class twelfth *
Father's Name *
Father's Qualification
Father's Occupation *
Mother's Name *
Mother's Qualification
Mother's Occupation *
Caste *
Address
Mobile No. *
Email ID *
Your Present Activity/Job/Occupation/Career *
About Myself (Try to describe yourself in 3 to 4 words or more) *
Marital/Relationship Status *
Family Environment *
Your Hobbies *
SUCCESS for me is (describe it according to your wants) *
My Strength *
My Weakness *
I feel HAPPY when *
I get DISTURBED/IRRITATED when *
I get into HAPPY mood when I Do *
I get DISTURBED/IRRITATED when I Do   or   When someone *
Number Of Close FRIENDS (APPROX.) *
Relationship with your Friends *
What do you do in your LEISURE/FREE time *
As a Person I feel I am *
When others ask me for HELP, I help *
How many hours do you work ? *
And you work for (relate to above question) *
I am in SEARCH of *
The Credit for MY Achievements goes to (on a scale of one-to-five) *
1
2
3
4
5
My Hard work+Intelligence+Focus+My skills
Parents Efforts+Parents Support+Parents Blessings
Teacher's Guidance
Luck Factor
Others
My Achievements are *
I will to achieve my Career/Personal Targets in (write in years) *
How are YOU feeling after filling this form ? *
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