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Date of Birth should be provided as per Matriculation certificate
Name, Father's Name and Mother's Name should be provided as per Matriculation certificate

* Name

* Father's Name

Guardian's Name

* Mother's Name

* Date of Birth

* Gender

* Citizen of

* Identity Type

* Valid Identity Number

* Complete Address for Communication

* State

* City/Town/Village

* Country

* PIN

* Email

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* Mobile

Alternate Contact

Copy Complete Address for Communication to Permanent Address

* Permanent Address with District

* City

* State

* Country

* PIN

* Programme applied for:

I had mathematics as a subject in Class XII

Provide your Graduation Details

* Course Name

* Result

* Password

* Confirm Password

* Secret Question

* Secret Answer

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199042

I hereby declare that all the information provided is true and correct.

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