First Name *  

Last Name *  

Father's Name *  

Mother's Name *  

Gender * --Select-- Female

Martial Status * --Select-- Single Married

Aadhar Number *

Community * --Select-- General OC BC MBC SC ST Others

Other Community *

Religion *  

Physically Challenged * --Select-- Yes No

Family Annual Income * --Select-- Below 1 Lakh Per Annum Between 1 Lakh - 2 Lakh Per Annum Between 2 Lakh - 3 Lakh Per Annum Less than 3.5 Lakh Per Annum Above 3.5 Lakh Per Annum

Age *

University Registration Number *

Father Occupation *

Mother Occupation *

Is the Student first Generation learner * Select Anyone Yes No

Is the Student a single parent child * Select Anyone Yes No

Which year of graduation is the student pursuing * Select Anyone 4th Year 7th Semester 4th Year 8th Semester 3rd Year 5th Semester 3rd Year 6th Semester 2nd year 3rd Semester 2nd year 4th semester 1st Year 1st Semester 1st Year 2nd Semester

Year of Passout * Select Anyone 2024

Email-id *

Mobile Number *

Door No / Flat / Street *

Area / Location *

State *

District *

City *

Pin Code *

Declaration

I declare that all the above details are true to the best of my knowledge. I intend to attend the scheduled training classes and would participate in all the events conducted as part of the Training program. I consent to the disclosure of my personal information to project donors.