Applicant Name:*

[ Please do not use any prefix such as Mr. or Ms. etc ]
[ Name as recorded in the Matriculation/Secondary Examination Certificate ]

Father's Name:*

[Do not use any prefix such as Shri or Dr. Etc.]

Mother Name:*

[Do not use any prefix such as Smt Etc.]

Date of Birth:*

[ Date of Birth as recorded in the Matriculation Examination Certificate/Any Valid Proof ]

Gender:*

Gender Male Female Transgender

Nationality:*

Nationality Indian Other

Are you a Bonafide Resident of Uttarakhand ?:*

Bonafide Yes No

Category:*

Category General(UR) Economically Weaker Section(EWS) Other Backward Caste(OBC) Scheduled Caste(SC) Scheduled Tribes(ST)

Sub Category:*

Sub Category D.F.F. Military Person(MP)/Dependent Physical Handicap(PH) None

For Claiming Reservation Facility For Cerificate Holder in NCC, NCC CERTIFICATE PASSED:*

Select One A B C None

Mobile Number :*

[ 10 Digit Mobile Number ]

Qualifying Examination:*

➤View Qualification Details. ➤

Qualifying Examination Appeared/Passed:*

Select One Appeared Passed

Examination center City Name-1:*

Examination center City Name-2:*

Aadhar Number :

CORRESPONDENCE ADDRESS [ पत्राचार का पता ]
Address :*	[ Don't Enter Your Name In The Address Field's ]
State:*	select state andaman and nicobar islands andhra pradesh arunachal pradesh assam bihar chandigarh chattisgarh dadra and nagar haveli daman and diu delhi goa gujarat haryana himachal pradesh jammu and kashmir jharkhand karnataka kerala lakshadweep madhya pradesh maharashtra manipur meghalaya mizoram nagaland orissa pondicherry punjab rajasthan sikkim tamil nadu tripura uttarakhand uttar Pradesh west bengal other
District :*
Pin Code:*

PERMANENT ADDRESS [ स्थाई पता ] is Same as Correspondence Address.
Address :*	[ Don't Enter Your Name In The Address Field's ]
State:*	select state andaman and nicobar islands andhra pradesh arunachal pradesh assam bihar chandigarh chattisgarh dadra and nagar haveli daman and diu delhi goa gujarat haryana himachal pradesh jammu and kashmir jharkhand karnataka kerala lakshadweep madhya pradesh maharashtra manipur meghalaya mizoram nagaland orissa pondicherry punjab rajasthan sikkim tamil nadu tripura uttarakhand uttar Pradesh west bengal other
District :*
Pin Code:*

E-Mail Address: / Confirm E-Mail Address:

Password:* / Confirm Password:*(8 to 12 character)
[ This Password will be use to complete Pending Registration Form/Print Filled up Form ]

Not Allowed in Password ➤ Space,",',~,`,Comma,=

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I hereby declare that the particulars filled are true, correct and complete to the best of my knowledge and belief and nothing has been concealed, In case any of the information is found to be false, incorrect or misleading at any stage I shall have no claim against cancellation of my candidature and/or taking other legal action as deemed fit by U.B.T.E.R.

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