Institute Information :

Study Centre Name* Address
State* Pin Code*
District* Phone No*
Block* Email*

Information About Centre Head :

Name of Study Centre head Upload Photo
Phone No* Upload ID Proof (voter/Aadhar)
Email* Upload Pan Card
Address* Upload Trade Lisence of Centre
Block* Upload Payment Slip
I hereby certify that the context stated above are correct and true to my knowledge and belief and hereby confirm that our Organization / Society / Trust is free from any legal / official disputes whatsover.I accept that any facts stated above. I found incorrect will automatically result in cancellation for nominations associate.However I will have no right whatsover to fight / challenge legally against the judgment in any court of law. All disputes are subject to Ghatal Jurisdiction only.