State* Select State Andaman and Nicobar Islands Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli Daman and Diu Delhi Goa Gujrat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Lakshadweep Madhya Pradesh Madhya Pradesh (MP) Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Puducherry Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal

District*

Address*

Block*

Centre Name*

Phone Number*

Pin Code*

Email*

Name*

Course Name* --Select Course-- CO - 101 COMPUTER FUNDAMENTALS CO - 102 OPERATING SYSTEM CO - 103 MS - OFFICE CO - 104 INTERNET CO - 105 DTP CO - 201 COMPUTER FUNDAMENTALS CO - 202 OPERATING SYSTEM CO - 203 MS - OFFICE CO - 204 INTERNET CO - 205 ACCOUNTING CONCEPT CO - 206 ACCOUNTING WITH TALLY AND GST CO - 301 COMPUTER FUNDAMENTALS CO - 302 OPERATING SYSTEM CO - 303 MS - OFFICE CO - 304 ADVANCE ACCOUNTING CONCEPT CO - 305 ADVANCE ACCOUNTING WITH TALLY PRIME CO - 306 BANKING & INSURANCE CO - 307 DIRECT TAX WITH TALLY PRIME CO - 309 AUDITING CO - 401 COMPUTER FUNDAMENTALS CO - 402 OPERATING SYSTEM CO - 403 MS - OFFICE CO - 404 INTERNET CO – 308 INDIRECT TAX WITH TALLY PRIME CO – 310 COMPANY LAW CO – 311 PORT FOLIO MANAGEMENT

Mother's Name*

Maritul Status* Single Married

Husband's Name

Referance ID

Nationality Indian Others

Scheme Name

Father's Name*

Gender* Male Female Others

Qualification*

Caste*

Religion* Select Religion Hinduism Islam other

Date of Birth*

Scheme Approved