Candidate Name
Date of Birth Gender Your Email Mobile No Alternate No Address
Disability Type —Please choose an option—BlindnessLow-VisionLeprosy Cured PersonHearing Impairment(Hard of Hearing ,Deaf)Locomotor DisabilityDwarfismIntellectual DisabilityMental IllnessAutism Spectrum DisorderCerebral PalsyMuscular DystrophyChronic Neurological ConditionsSpecific Learning DisabilityMultiple SclerosisSpeech and Language DisabilityThalassaemiaHaemophiliaSickle Cell DiseaseMultiple Disability Including Deaf-BlindnessAcid Attack VictimsParkinson's Disease
Qualification —Please choose an option—SSLC/PUCDiploma/ITIBachelor of ArtsBachelor of ScienceBachelor of CommerceBachelor of Engg/TechBMS/BBA/BBSBachelor of LawBachelor of Medicine (MBBS)BCAMCAMBAMCOMIIM 5-year Integrated Mgmt. Program Are you UG/PG in computer Science/IT —Please choose an option—YesNo
Technical Skills Experience (If any)
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