DIET PILIBHIT

D.EL.ED. ALUMNUS ENTRY FORM (Note- Fill All the Details in CAPITAL LETTER)

College Code

College Name

BATCH

Registration No. ( If You Have )

Trainee Name

Father's Name

Mother's Name

Gender Male Female

Date Of Birth

Physically Handicapped (दिव्यांग)?
Yes No

Select Category

Profession :
Teacher Other

If Other, Please Specify

Aadhaar No. (ONLY 12 DIGITS, WITHOUT SPACE)

Mobile No.(ONLY 10 DIGITS, NOT Starting from '6')

Whatsapp No.(ONLY 10 DIGITS)

Telegram No.(ONLY 10 DIGITS)

Home Address

Current Address

Upload Photo

(Note- Uploaded File should be in jpeg / jpg format and size should be 50KB-100KB)