Please go through the Guidelines before Filling the Application Form

Fields marked with the asterisk (*) are mandatory

Name of the Applicant *

Name should be as per Educational Documents

Father's Mother's Husband's Name *

Father/Mother Name should be as per Educational Documents

Date of Birth *

Gender * Male Female Others

Email *

Mobile No.*

Don't prefix 0, (Only Enter 10 Digit Mobile Number)

User Name*  

User name must be between 8 to 16 characters.No special character allowed.

Password *

Must be alphanumeric between 8 to 16 characters.

Confirm Password *

Please enter the code shown below*

Secure Code

Enter captcha !