Utkarsh Bangla Monitoring Platform

Participant name

Mr/Mrs/Ms *

First Name *

Middle Name

Last Name *

Contact Information

Mobile No *

Email ID

Permanent Address

Address *

City/Town (Permanent) *

PIN (Permanent) *

State (Permanent) *

District (Permanent) *

Block / Municipality (Permanent) *

Personal Details

Guardian’s First Name

Guardian’s Middle Name

Guardian’s Last Name

Relationship with Guardian *

Gender M/F *

Date of Birth *

Caste

Religion

Marital Status

Educational Details

Educational Qualification *

Qualification Status *

Employment Status *

Training Requirement

Course *

If you require training in any other subject, please mention