Apply for Certificate - Official Portal

1

Personal Information

Applicant personal identity details

Full Name *

Full name is required.

Father / Husband Name *

Father / Husband name is required.

Date of Birth *

Date of birth is required.

Roll Number *

Roll Number is required.

Mobile Number *

A valid mobile number is required.

Email Address *

A valid email address is required.

2

Address Details

Permanent / Residential location

Full Residential Address *

Full residential address is required.

City / Town *

City / Town is required.

State *

State is required.

Pincode / Postal Code *

A valid pincode is required.

3

Course Selection

Select the course you are applying for

Course *

Please select a course.

4

Government Identity Information

Identity verification details

Government ID Type *

Please select an ID type.

5

Required Document Uploads

Upload or capture high-resolution photos (Max 2MB photo, 5MB ID cards)

1. Applicant Profile Photo *

Upload / Take Photo

JPEG, PNG, WebP (Max 2MB)

2. Government ID Front *

ID Front Side

JPEG, PNG, WebP (Max 5MB)

3. Government ID Back (Optional)

ID Back Side

JPEG, PNG, WebP (Max 5MB)

I confirm that the information provided by me is correct and I authorize the organization to process my application and verify my documents.

You must accept the declaration to submit.

Nisha Rajput Coaching Certificate Application Form

Personal Information

Address Details

Course Selection

Government Identity Information

Required Document Uploads