Participant Registration

First Name *

Last Name *

Date of Birth *

Gender Select Gender Male Female Other

Email *

Mobile *

WhatsApp Number

Aadhaar Number

Designation *

Subject *

Department / Institution *

Affiliating University *

Institution Address *

City / District *

State *

PIN Code *

Category * Select Category General SC ST OBC Minority

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Service Details

Date of First Appointment *

Status of Appointment * Select Status Permanent Temporary Adhoc

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UGC ASC / HRDC / MMTTC Courses Attended

Orientation Institution

From

To

Refresher 1 Institution

From

To

Refresher 2 Institution

From

To

Refresher 3 Institution

From

To

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Upload Photo *

Upload Signature *

Upload NOC *

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