Year* :
District* :
Class* :
Name of the Applicant* :
Do not Enter Special Characters
* As per Matriculation Certificate(Do
not use Salutation before Name Like: Mr/Ms/Mrs. etc.)
Father's/Guardian's Name* :
Do not Enter Special Characters
* As per Matriculation Certificate(Do
not use Salutation before Name Like: Mr/Ms/Mrs. etc.)
Date of Birth* :
* As per Matriculation Certificate
Physically Disabled :
Note: If yes, then submit attested Medical
Board Certificate
Gender* :
Category*:
*
year of Birth (As per Aadhaar)*
:
Email ID* :
**
Please Enter Correct Email ID
Password* :
*
Please Enter Correct Password
* Eg: @abc1234
Note: (Minimum eight characters, at least one letter, one number and one special
character.)