Home > Paid Course
Name
Recent Colour Passport Size Photo
Father's/ Husband's Name
Address
P.O.
P.S.
PIN Code
District
State
Date of Birth
Sex —Please choose an option—MaleFemaleOthers
Caste —Please choose an option—GenSCSTOBCMinority
ID Proof [AAdhar/Voter Card/PAN Card/Driving Licence]
ID Proof Document Number
Religion —Please choose an option—HinduismMuslimChristianOthers
Education Qualification
Education Qualification Proof
Applied Couse Name
Applied Couse Duration —Please choose an option—3 Months6 Months12 Months24 Months36 Months
Do you Have Any Technical Course YesNo
If Yes then Type the duration of course
Upload The course certificate
Date Of Application
Date Of Registration
Mobile Number 1
Mobile Number 2
Email Id
I hereby declare that all the statements given by me are firmly true. If any of my statements found untrue in any stage, I shall be liable for any other action under extent rules.
