Registration Request Form

Full Name

Please enter your full name.

Employee ID

Designation

Please select your designation.

Date of Birth

Please select your date of birth.

PAN Number

Please enter a valid PAN number (format: ABCDE1234F).

Date of Joining

Please select your date of joining.

Appointment Type

Please select an appointment type.

Campus

Please select a campus.

Department/Centre/Section

Please select a department.

Email ID

Please enter a valid email address.

Mobile Number

Please enter a valid 10-digit mobile number.

Upload Photo

Click to upload or drag and drop

JPEG, JPG format only
Recommended: Height and Width must be within 200px to 300px

Uploading...

Please upload a profile photo.

Centre for e-Governance