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Online Applicant Registration Form
Enter your personal details.
Applicant Name
*
Enter Applicant Name
Enter a valid Name
Mobile Number
*
Enter Mobile No.
Enter A Valid Mobile-No
Email
*
Enter Email
Invalid email address
DOB
*
Enter DOB
Gender
*
Select Gender
Male
Female
TransGender
Select Gender
Address
*
Enter Address
Upload your documents.
Aadhar No.
*
Enter Aadhar No.
Enter a valid Aadhar No.
Upload Aadhar
*
Upload Aadhar
Only .jpg,.png,.jpeg,.pdf Files are allowed
PAN No.
*
Please Enter Pan No.
Enter a valid Pan No.
Upload PAN
*
Upload Pan
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Annual Income
*
Enter Annual Income
Enter a valid Annual Income
Income should be 50,000 or more P.A.
Upload Income Cert.
*
Upload Income Cert.
Only .pdf Files are allowed
Profile Image
*
Upload Profile Image
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Select Quota
*
-- Select Quota--
General
O.B.C. (Other Backward Class)
S.C. (Scheduled Caste)
S.T. (Scheduled Tribe)
M.P/M.L.A
Govt. Employee(Above 50 yrs)
Local Body Employee
EX-Armyman & there department
Paramilitary Forces
Select Quota
Upload Quota Cert.
*
Upload Quota Cert.
Only .pdf Files are allowed
Special Category.
Handicapped
Upload Handicapped Cert.
Only .pdf Files are allowed
Senior Citizen
Upload Senior itizen Cert.
Only .pdf Files are allowed
Enter your nominee details.
Nominee Name
*
Enter Nominee Name
Enter valid Nominee Name
Nominee Relation
*
Enter Nominee Relation
Enter valid Nominee Relation
Father Name
*
Enter Father Name
Enter valid Father Name
Enter your bank details.
Account Holder Name
*
Enter Account Holder Name
Enter valid Name
Bank Name
*
Enter Bank Name
Branch Name
*
Enter Branch Name
Account No.
*
Enter Account No.
Confirm Account No.
*
Confirm Account No.
Account No. Should be Same
IFSC Code
*
Enter IFSC Code
Payment Type
*
Select Payment Type
Full Payment
Partial Payment(Installment)
Select payment type
I Hereby declare that information furnished above is true and correct in every respect and in case any information is found incorrect even partially the Authority shall be liable to rejected.