SCERT

Personal Details.

Salutation

First Name

Middle Name

Last Name

Father Name

Mother Name

Gender

Category

DOB

Age as on 1st July, 2023

Qualification

Phone Number

Alt. Phone Number

Communication Details.

Permanent address

Address

Post office

Police Station

District

State

Pincode

Correspondence Address

Correspondence Address same as Permanent address?

Address

Post office

Police Station

District

State

Pincode

Qualification Details.

Higher Secondary (12^thClass) Examination Details.

Board

Medium

Stream

Year of Passing

Total Marks

Obtained Marks

Percentage

Questionaries’.

Do you belong to Bodo community?

Do you belong to Karbi Community?

Persons with Benchmark Disability (Disability of 40 % or above)?

Documents Upload.

Photo

Signature

Class 10 Admit Card

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Class 12 Marksheet

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Declaration.

I hearby, declare that the information provided in this form is true and accurate to the best of my knowledge.

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Goverment of Assam

Office Of The Director

State Council of Educational Research and Training (SCERT), Assam

Kahilipara, Guwahati - 781019