Samagra Applicants Details :
SamagraId :
Name: Last Name
Father's Name: Mother's Name
Mobile No: Email Address :
Gender: DOB :
Category:
Address :
Registration:Enter Your Details
SamagraID :
Name as Per 10th Marksheet: *   First Name *
Middle Name
Last Name
Confirm Name as per 10th Marksheet: *  First Name*
Middle Name
Last Name
Gender:* Confirm Gender : *
DOB *   Enter DOB Again *  
Father Name * Mother Name *
Confirm Father Name * Mother Name *
Category : * Enter Selected Category : *
Religion : * Religion : *
Email Address : * Confirm Email Address : *  
Enter Active Mobile Number : * Enter Confirm Active Mobile No : *


Correspondence Address Details/छात्र/छात्रा का वर्तमान पता: Permanent Address
Are You Studying in Institute which is Out of Madhya Pradesh./ क्या आप मध्य प्रदेश से बाहर स्थित संस्था में अध्ययनरत है?
State : * State : *
Correspondant Address : * Permanent Address : *
District : * District : *
PIN Code : * PIN Code : *
VidhanSabha : *
   My Permanent Address is same as Correspondance Address

DECLARATION / घोषणा

मैं घोषणा करता हूँ कि उपरोक्त जानकारी सही है एवं मेरी कक्षा १० की मार्कशीट में अंकित जानकारी के अनुसार है. I declare that I have entered all the above information correctly and as per my 10th Board Marksheet.

Please Click on Check Box



Error Message/ त्रुटि सन्देश