Registration Details
A. Personal Details
Name of the Candidate * Initial           Name
Gender *     
Date of Birth * Date    Month          Year
Mobile No. *    
email-ID *    
Father's Name  
Mother's Name  
Are you a Differently Abled Person?  
B. Address Details
Door No.*       Street Name*
Local Body*
  District*                     Taluk*                       Pincode*
C. Communal Details
  Religion                    Community             Certificate No.
D. Educational Qualification
Qualification*           Name of Degree                Year of Completion
Institute Name                                               Place
E. Course Opted
Training Location/Center*
F. Proof
  Aadhar Card No.* Proof of Educational Qualification (Certificate No)
G. Bank Details (should be in Candidate name to receive the Travelling Allowance. If not available, kindly open the account and give details before training)
  Bank Name Branch Name
IFSC Code Account No.
Account Holder Name
H. Photo File Upload
  Photograph of the Candidate
(Image format : jpg, jpeg)*

Allowed Photo Size - 3.5 cm x 4.5  cm (20 KB -50 KB)
I. Experience (Optional)
Job Start Date     Job End Date
 Job Type
J. Verification and Declaration
Verification Code
Enter Verification Code

   I declare that the above particulars furnished by me are correct to the best of my knowledge and I abide by the rules of BSNL during the Training period.