STUDENT REGISTRATION

All Fields marked with (* ) are mandatory

CANDIDATE REGISTRATION FORM

Candidate Full Name* *

Student Name *

Upload Profile Picture*: *

Phone Number: *

Email Address: *

Gender *

Male

Female

TransGender

Date Of Birth: *

Marital Status: *

Domicile State: *

Domicile District: *

Category: *

Religion: *

Any Disability: * *

Yes

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Mother's Name: *

Father's Name / Guardian's Name: *

Identification: * *

Alternate Id

Adhaar Id

Permanent Address

Address:*

State:

District:

Tehsil/Mandal/Block:*

Village/Town/City:*

Pincode:

Constituency:

Same As Permanent Address:*

Address:*

State:*

District:*

Tehsil/Mandal/Block:*

Village/Town/City:*

Pincode:*

Constituency:*

Bank Details:

Account Holder Name:

Account Number:

IFSC Code:

Bank Name:

Bank Address:

10th Class:

Education:*

Year Of Passing:*

Upload Supporting Document:*

Higher Education:

Education:*

Year Of Passing:*

Upload Supporting Document:*

Higher Education:

Pre-Training Status:*

Heard about Us?:*

Course Preference:

Select Job Role:*

Select Sub Sector:*

Declaration Undertaking

Training Partner/ Project Implementing Agency (PIA)/ Special Projects Implementing Agency(SPIA) and its Training Centre/Location confirms to the following by saving the candidate for registration:

1. The data entered is true and verified.

2. Agrees to ensure upload of the candidate photo and the proof for District of Domicile (Aadhaar/PAN/Voter card copy/Birth Certificate issued by govt./BPL Card/Domicile Certificate/Driving License/Identity proof by Gazetted officers/Jail Identification Card / Number/Letter of domicile from SDM / DM / Govt. authority/National Population Register (NPR) Card/Permanent Residential Certificate (PRC)/Passport/Ration Card/ST/SC Certificate/School leaving certificate / 10th certificate/Other) and proof for Person with Disability.

3. Agrees to upload alternate id (PAN/Voter card copy) only for candidates with domicile (place of belonging) as Jammu and Kashmir or North East (Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura). Further the Training Partner/PIA/SPIA and its Training Centre/Location understands and accepts that misrepresentation of candidate information may lead to blacklisting/cancellation of the Training Centre / Training Partner / Project Implementing Agency/Project, and disciplinary actions be initiated as per the decision of PMKVY Monitoring Committee.

4. I understand that if the domicile district of the candidate and the training center district is the same, no Boarding & Lodging pay-out will be made.

5. I understand that candidate details, employment letter, salary slip, bank statement and other relevant documents can be shared with relevant stakeholders in ecosystem for the purpose of placement verification as well as facilitating placement for candidate.

6. I have informed candidates that the training/orientation and certification by NSDC/SSC is not in substitution of the statutory requirement of specific license/diploma/degree or any other certificate for taking up or performing the job for which there is a requirement under any statute for any specific license/diploma/degree or any other certificate for taking up or performing that job.

I Agree to the Terms and Conditions.