Free Coaching for Group-IV, VRO


Note :
* All the scanned documents should be in*.jpg OR *.jpeg OR *.gif format and size not be more than 100 KB per document.
* Information provided must match with the certificate scanned which will be verified at the time of admission.
  # Optional Fields
(Fill up in Capital Letters)
Personal Information
1. Name of the Candidate with Surname
2. Father's Name

(Please do not use any prefix such as Mr. or Shri. or Prof. or Dr. etc.)
3. Mother's Name

(Please do not use any prefix such as Miss. or Shri. or Mrs etc.)
4. Date of Birth (As per SSC Memo)    (dd-mm-yyyy)
5. Gender Male Female
6. Caste with Category   
7. Educational Qualification
8. Annual Income of Parent / Guardian (e.g., 100000 (INR))
9. Is Physically Challenged? Yes No
10. Aadhaar Number
11. Mobile Number
12. eMail ID
13. Native District
14. Address for Correspondence
District Mandal
Village Street #
House/Door Number PIN Code
15. Academic Details
Name of the Examination Hall Ticket Number Max. Marks Obtained Marks Year of Passing Institute Name Name of the Board/University
X Class
Graduation #
16. Details of Coaching availed earlier for Employee Skill Development & Training in the Govt.,
    Study Circles
*All the scaned documents should be in *.jpg OR *.jpeg format and size not be more than 100KB
17. Photograph of the Applicant
18. Signature of the Applicant
19. SSC Memo
20. Intermediat Memo
21. Degree Memo *
22. Caste Certificate
23. Income Certificate
24. Aadhaar Card
25. Acknowledgement of Group-IV, VRO Notification
 I swear that the facts mentioned above are true and correct. If any information is later found to be incorrect, wrong or misleading, I shall abide by any penal action by the Management.