Enrollment Date * Unique ID type * — Select — PAN Card Aadhar Card Unique ID Number * First Name * Last Name * Gender * — Select — Male Female Date of Birth * Email Id * Mobile number * Education Qualification * — Select — Diploma BSc Computer Science BSc Information Technology MSc Computer Science MSc Information Technology BTech Computer Science BTech Information Technology MTech Computer Science MTech Information Technology BCA MCA BSc Electronics MSc Electronics BTech Electronics BTech Electronics & Communication BTech Electrical & Electronics Engineering MTech Electronics MTech Electronics & Communication Others (Specify in next field) If any other please specify Designation * Name of the host College/ University hosting the TechSaksham FDP * — Select — Sant Longowal Institute of Engineering & Technology (SLIET) Punjab Kanpur University VGEC Chandkheda MVGR College of Engineering Vidya Pratishthan Group of College Jagat Guru Nanak Dev Punjab State Open University, Patiala, GEC Hassan APS University Rewa ASAP Kerala College Name (Currently working with) * College Address * College District * College State * College Pin Code * Track enrolled for * — Select — AI CC I disclose the information willingly for it to be used by the authorities for the purpose of the program. Also, the authorities have the right to use the pictures, videos and above mentioned details for media surveys. Yes No