Course Name
Batch No
Full Name (Block Letters)*
Profile Picture
Designation
Mobile number (10 Digit without country code)*
Aadhaar Number (UID) 12 Digits without spaces*
Aadhaar Card
Pan Number (UID) 10 Characters without spaces*
Pan Card
E-Mail ID (Official)*
E-Mail ID (Personal)*
Address of Sponsoring Organization*
GST Number*
Phone number of Organization (11 Digit number starting with 0)*
E-Mail ID of the Organization*
Category- Required for reporting to GoI* GeneralSCSTNTOBCMinority
Physically Handicap* YesNo
Fee Paid?* YesNo
Payment Details* NEFTChequeDemand DraftOther
Instrument / UTR Number*
Payment Date*
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