Candidate Name *
Date Of Birth *
Gender * Male/Female Male Female
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Highest Qualification * Select One 5th 8th 10th 10th+2 Graduate
Address *
State * Select One Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Goa Gujarat Haryana Himachal Pradesh Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal Delhi Jammu and Kashmir
District * Select One Anantapur Chittoor East Godavari Guntur Kadapa Krishna Kurnool Nellore Prakasam Srikakulam Visakhapatnam Vizianagaram West Godavari
District * Select One Anjaw Siang Changlang Dibang Valley East Kameng East Siang Kamle Kra Daadi Kurung Kumey Lepa Rada * Lohit Longding Lower Dibang Valley Lower Siang Lower Subansiri Namsai Pakke Kessang * Papum Pare Shi Yomi * Tawang Tirap Upper Siang Upper Subansiri West Kameng West Siang
District * Select One Bajali * Baksa Barpeta Biswanath Bongaigaon Cachar Charaideo Chirang Darrang Dhemaji Dhubri Dibrugarh Dima Hasao Goalpara Golaghat Hailakandi Hojai Jorhat Kamrup Kamrup Metropolitan Karbi Anglong Karimganj Kokrajhar Lakhimpur Majuli Morigaon Nagaon Nalbari Sivasagar Sonitpur South Salmara-Mankachar Tinsukia Udalguri West Karbi Anglong
District * Select One Araria Arwal Aurangabad Banka Begusarai Bhagalpur Bhojpur Buxar Darbhanga East Champaran Gaya Gopalganj Jamui Jehanabad Kaimur Katihar Khagaria Kishanganj Lakhisarai Madhepura Madhubani Munger Muzaffarpur Nalanda Nawada Patna Purnia Rohtas Saharsa Samastipur Saran Sheikhpura Sheohar Sitamarhi Siwan Supaul Vaishali West Champaran
District * Select One Balod Baloda Bazar Balrampur Ramanujganj* Bastar Bemetara Bijapur Bilaspur Dantewada Dhamtari Durg Gariaband Gaurela Pendra Marwahi* Janjgir Champa Jashpur Kabirdham Kanker Kondagaon Korba Koriya Mahasamund Mungeli Narayanpur Raigarh Raipur Rajnandgaon Sukma Surajpur Surguja
District * Select One North Goa South Goa
District * Select One Angul Balangir Balasore Bargarh Bhadrak Boudh Cuttack Debagarh Dhenkanal Gajapati Ganjam Jagatsinghpur Jajpur Jharsuguda Kalahandi Kandhamal Kendrapara Kendujhar Khordha * Koraput Malkangiri Mayurbhanj Nabarangpur Nayagarh Nuapada Puri Rayagada Sambalpur Subarnapur Sundergarh
District * Select One Amritsar Barnala Bathinda Faridkot Fatehgarh Sahib Fazilka Firozpur Gurdaspur Hoshiarpur Jalandhar Kapurthala Ludhiana Malerkotla * Mansa Moga Mohali Muktsar Pathankot Patiala Rupnagar Sangrur Shaheed Bhagat Singh Nagar Tarn Taran
District * Select One Ajmer Alwar Banswara Baran Barmer Bharatpur Bhilwara Bikaner Bundi Chittorgarh Churu Dausa Dholpur Dungarpur Sri Ganganagar Hanumangarh Jaipur Jaisalmer Jalore Jhalawar Jhunjhunu Jodhpur Karauli Kota Nagaur Pali Pratapgarh Rajsamand Sawai Madhopur Sikar Sirohi Tonk Udaipur
District * Select One East Sikkim North Sikkim South Sikkim West Sikkim
District * Select One Ariyalur Chengalpattu * Chennai Coimbatore Cuddalore Dharmapuri Dindigul Erode Kallakurichi * Kanchipuram Kanyakumari Karur Krishnagiri Madurai Mayiladuthurai* Nagapattinam Namakkal Nilgiris Perambalur Pudukkottai Ramanathapuram Ranipet* Salem Sivaganga Tenkasi * Thanjavur Theni Thoothukudi Tiruchirappalli Tirunelveli Tirupattur* Tiruppur Tiruvallur Tiruvannamalai Tiruvarur Vellore Viluppuram Virudhunagar
District * Select One Adilabad Bhadradri Kothagudem Hyderabad Jagtial Jangaon Jayashankar Bhupalpally Jogulamba Gadwal Kamareddy Karimnagar Khammam Komaram Bheem Mahabubabad Mahbubnagar Mancherial Medak Medchal Mulugu * Nagarkurnool Nalgonda Narayanpet * Nirmal Nizamabad Peddapalli Rajanna Sircilla Ranga Reddy Sangareddy Siddipet Suryapet Vikarabad Wanaparthy Warangal Hanamkonda Yadadri Bhuvanagiri
District * Select One Dhalai Gomati Khowai North Tripura Sepahijala South Tripura Unakoti West Tripura
District * Select One South Goa
District * Select One Agra Aligarh Prayagraj* Ambedkar Nagar Amethi * Amroha * Auraiya Azamgarh Baghpat Bahraich Ballia Balrampur Banda Barabanki Bareilly Basti Bhadohi Bijnor Budaun Bulandshahr Chandauli Chitrakoot Deoria Etah Etawah Ayodhya * Farrukhabad Fatehpur Firozabad Gautam Buddha Nagar Ghaziabad Ghazipur Gonda Gorakhpur Hamirpur Hapur * Hardoi Hathras * Jalaun Jaunpur Jhansi Kannauj Kanpur Dehat * Kanpur Nagar Kasganj * Kaushambi Kheri Kushinagar Lalitpur Lucknow Maharajganj Mahoba Mainpuri Mathura Mau Meerut Mirzapur Moradabad Muzaffarnagar Pilibhit Pratapgarh Raebareli Rampur Saharanpur Sambhal * Sant Kabir Nagar Shahjahanpur Shamli * Shravasti Siddharthnagar Sitapur Sonbhadra Sultanpur Unnao Varanasi
District * Select One Ahmedabad Amreli Anand Aravalli Banaskantha Bharuch Bhavnagar Botad Chhota Udaipur Dahod Dang Devbhoomi Dwarka Gandhinagar Gir Somnath Jamnagar Junagadh Kheda Kutch Mahisagar Mehsana Morbi Narmada Navsari Panchmahal Patan Porbandar Rajkot Sabarkantha Surat Surendranagar Tapi Vadodara Valsad
District * Select One Ambala Bhiwani Charkhi Dadri Faridabad Fatehabad Gurugram * Hisar Jhajjar Jind Kaithal Karnal Kurukshetra Mahendragarh Mewat Palwal Panchkula Panipat Rewari Rohtak Sirsa Sonipat Yamunanagar
District * Select One Bilaspur Chamba Hamirpur Kangra Kinnaur Kullu Lahaul Spiti Mandi Shimla Sirmaur Solan Una
District * Select One Anantnag Bandipora Baramulla Budgam Doda Ganderbal Jammu Kathua Kishtwar Kulgam Kupwara Poonch Pulwama Rajouri Ramban Reasi Samba Shopian Srinagar Udhampur
District * Select One Bokaro Chatra Deoghar Dhanbad Dumka East Singhbhum Garhwa Giridih Godda Gumla Hazaribagh Jamtara Khunti Koderma Latehar Lohardaga Pakur Palamu Ramgarh Ranchi Sahebganj Seraikela Kharsawan Simdega West Singhbhum
District * Select One Bagalkot Bangalore Rural Bangalore Urban Belgaum Bellary Bidar Chamarajanagar Chikkaballapur Chikkamagaluru Chitradurga Dakshina Kannada Davanagere Dharwad Gadag Gulbarga * Hassan Haveri Kodagu Kolar Koppal Mandya Mysore Raichur Ramanagara Shimoga Tumkur Udupi Uttara Kannada Vijayanagara * Vijayapura * Yadgir
District * Select One Alappuzha Ernakulam Idukki Kannur Kasaragod Kollam Kottayam Kozhikode Malappuram Palakkad Pathanamthitta Thiruvananthapuram Thrissur Wayanad
District * Select One Agar Malwa Alirajpur Anuppur Ashoknagar Balaghat Barwani Betul Bhind Bhopal Burhanpur Chachaura* Chhatarpur Chhindwara Damoh Datia Dewas Dhar Dindori Guna Gwalior Harda Hoshangabad Indore Jabalpur Jhabua Katni Khandwa Khargone Maihar* Mandla Mandsaur Morena Nagda* Narsinghpur Neemuch Niwari * Panna Raisen Rajgarh Ratlam Rewa Sagar Satna Sehore Seoni Shahdol Shajapur Sheopur Shivpuri Sidhi Singrauli Tikamgarh Ujjain Umaria Vidisha
District * Select One Ahmednagar Akola Amravati Aurangabad Beed Bhandara Buldhana Chandrapur Dhule Gadchiroli Gondia Hingoli Jalgaon Jalna Kolhapur Latur Mumbai City Mumbai Suburban Nagpur Nanded Nandurbar Nashik Osmanabad Palghar Parbhani Pune Raigad Ratnagiri Sangli Satara Sindhudurg Solapur Thane Wardha Washim Yavatmal
District * Select One Bishnupur Chandel Churachandpur Imphal East Imphal West Jiribam Kakching Kamjong Kangpokpi Noney Pherzawl Senapati Tamenglong Tengnoupal Thoubal Ukhrul
District * Select One East Garo Hills East Jaintia Hills East Khasi Hills North Garo Hills Ri Bhoi South Garo Hills South West Garo Hills South West Khasi Hills West Garo Hills West Jaintia Hills West Khasi Hills
District * Select One Aizawl Champhai Hnahthial Khawzawl Kolasib Lawngtlai Lunglei Mamit Saiha Saitual Serchhip
District * Select One Mon Dimapur Kiphire Kohima Longleng Mokokchung Noklak Peren Phek Tuensang Wokha Zunheboto
District * Select One Almora Bageshwar Chamoli Champawat Dehradun Haridwar Nainital Pauri Pithoragarh Rudraprayag Tehri Udham Singh Nagar Uttarkashi
District * Select One Alipurduar Bankura Birbhum Cooch Behar Dakshin Dinajpur Darjeeling Hooghly Howrah Jalpaiguri Jhargram Kalimpong Kolkata Malda Murshidabad Nadia North 24 Parganas Paschim Bardhaman Paschim Medinipur Purba Bardhaman Purba Medinipur Purulia South 24 Parganas Uttar Dinajpur
District * Select One Central Delhi East Delhi New Delhi North Delhi North East Delhi North West Delhi Shahdara South Delhi South East Delhi South West Delhi West Delhi
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