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Registration Form

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Basic Details
Enrollment Date
Please enter valid enrollment date.
Unique Id Proof
Unique Id Proof Number
Full Name
Please enter valid firstname.
Email Address
Phone
Gender
Date of Birth
Address
Education Qualifications
Track
Family Details
Other Information
Do you have access to laptop/desktop?
Yes    No   
Please select yes or no.
Do you have Internet access?
Yes    No   
Please select yes or no.
Are you a physically disabled person?
Yes    No   
Please select yes or no.
Declaration
  • All the information above is true to my knowledge.
  • 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.
  • I will adhere to guidelines and complete the program.