Data Science Upskilling Program Admission Form

1.Personal Details

Full Name *

Date of Birth *

Gender *MaleFemaleOther

Nationality *

Email Address *

Contact Number *

2.Current Address

Street Address *

Apartment *

City *

State *

Postal Code *

Country *

3.Academic Background

Highest Qualification *

Institution Name *

Year of completion

Relevant Coursework (if any)

4.Professional Background (if any)

Current Job Title

Company Name

Relevant Skills ( Python, SQL)

Total Work Experience

5. Photo and Signature Upload

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Signature Upload *

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Date of Admission *

6.Additional Information

How did you hear about us? *Social MediaWebsiteReferralOther

Terms & conditions *I understand that MoxieTEK Training is committed to my success and offers a unique Pay After Placement scheme as a benefit to its students. I acknowledge and agree to the following terms:1. The total course fee for the Data Science & AI program is ₹50,000. 2. As a special advantage, I am required to pay only ₹25,000 upfront, which covers the full curriculum, placement training, internships, and career guidance, allowing me to focus on learning without immediate financial pressure. 3.The remaining ₹25,000 is payable only after I secure a placement through MoxieTEK Training’s placement drives, ensuring my investment aligns with my career growth. 4. I commit to fulfilling this financial obligation upon receiving a placement offer facilitated by MoxieTEK Training. 5. I confirm that I have read, understood, and agree to these terms. I appreciate this support and commitment to my career journey provided by MoxieTEK Training.

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