|
1.2
|
Applied As *
|
|
|
1.2
|
Center Name*
|
|
|
1.2
|
Center City/Town*
|
|
|
1.3
|
Exam Cycle *
|
|
|
1.4
|
Registration Fee Will Be Paid To? *
|
|
|
2.
Applicant's Personal Details
|
|
2.1
|
Applicant's full name *
|
( Full name as per the highest / latest qualification certificate or legal certificate
)
|
|
2.2.1
|
Father's Name *
|
( Full Name As Per Educational/Legal Certificate )
|
|
2.2.2
|
Mother's Name *
|
( Full Name As Per Educational/Legal Certificate )
|
|
2.3
|
Gender*
|
|
|
2.4
|
Date of Birth * (dd-Mon-yyyy)
|
|
|
2.5
|
Marital Status*
|
|
|
2.6
|
Category*
|
|
|
2.7
|
Handicapped*
|
|
|
2.8
|
Ex-Serviceman*
|
|
|
2.9
|
Religion *
|
|
|
3. Contact Details
|
|
3.2
|
Mobile Number *
|
|
|
3.3
|
Email Address
|
|
|
4. Permanent Address Details
|
|
4.1
|
Address Line1 *
|
|
|
4.2
|
Address Line2 *
|
|
|
4.3
|
Address Line3
|
|
|
4.4
|
City Name *
|
|
|
4.5
|
State *
|
|
|
4.6
|
Pin Code *
|
|
|
5.
Correspondence Details
|
|
5.1
|
Address Line1 *
|
|
|
5.2
|
Address Line2*
|
|
|
5.3
|
Address Line3
|
|
|
5.4
|
City Name *
|
|
|
5.5
|
State *
|
|
|
5.6
|
Pin Code *
|
|
|
6. Educational / Qualification Details
|
|
6.1
|
Highest Educational Qualification *
|
|
|
6.2
|
Year of Passing *
|
|
|
6.3
|
If direct, experience in years
|
|
|
7. Identification Details
|
|
7.1
|
Aadhar Card Number
|
|
|
7.2
|
Upload Photo *
( JPG,JPEG,GIF,PNG image with size upto 50 KB )
|
Upload Signature *
( JPG,JPEG,GIF,PNG image with size upto 50 KB )
|
|
7.4
|
Visible Distinguishing Mark *
|
|
|
