Registration for Payment / Statutory Programs
Full Name (To appear on Certificate):
*
Father/ Mother/ Guardian Name :
*
Date of Birth :
*
* Please select Date of Birth
Gender :
*
-Select-
MALE
FEMALE
Qualification :
*
Mobile No. :
*
* Input digits (0 - 9)
* Please Enter Mobile No.
Email : (This will be your Login Id)
*
* Please Enter Office of Trainee
Online Course :
*
-Select-
Certificate Course on Urban Integrated Pest Management
Address for Communication :
*
* Please Enter Trainee Address
Company / Organization Name:
Company GSTIN No. :
Company / Office Address :
Upload Passport Photo (200x160 px)
(Only JPG files < 50 kb):
Only JPEG images are allowed
File Size > 50 Kb
Upload Qualification Certificate
(Only PDF Files < 2 Mb):
Only PDF Files are allowed
File Size > 2 MB