New User Self Registration
* indicates mandatory field
Registration Your Self
1. Applicant Name
:
*
2. Applicant Father Name
:
*
3. State
:
-Select-
ANDAMAN AND NICOBAR
ANDRA PRADESH
ARUNACHAL PRADESH
ASSAM
BIHAR
CHHATTISGARH
DADRA AND NAGAR HAVELI
DAMAN AND DIU
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU AND KASHMIR
JHARKHAND
KARNATAKA
KERALA
LAKSHADWEEP
MADYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
NCT DELHI
ODISHA
PUNJAB
RAJASTHAN
SIKKIM
TAMIL NADU
TRIPURA
UTTAR PRADESH
UTTARANCHAL
WEST BENGAL
*
4. District
:
-Select-
*
5. E-Mail ID
:
*
6. Mobile Number
:
*
7. Enter OTP
:
*
N.B: OTP will be sent to above Mobile number and Email Id.
If OTP not received click on Sent OTP button after
Sec
8. Applicant Address
:
*
(Maximum
Characters left:
200
)
9. PinCode
:
*
10. Password
:
*
11. Confirm Password
:
Passwords do not match.
*
12. Applicant Identity Proof
Voter Identity Card
13. Id Proof
Number
:
*
14. Upload
Id Proof
:
*
.pdf file ,should be less than 500kB