AI Careers for Women Registration Form

Personal Details

Full Name *

Date of Birth *

Age *

Email Address *

Phone Number *

Unique ID Card *

Unique ID Proof Number *

Gender *

College Details

College Name *

College Address *

State *

District *

PIN Code *

College Type *

College Year *

Branch *

Year of Graduation *

Family Background

Permanent Address *

State *

District *

PIN Code *

Guardian’s Name *

Guardian’s Contact Details *

Relationshp with Guardian *

Please specify (Others) *

Annual Family Income *

Declaration

All the information above is true to my knowledge. *

I disclose the information willingly for it to be used by the authorities for the purpose of the program. Also, the authorities have the right to use the pictures, videos and above-mentioned details for media surveys. *