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Online Agency Application Registration

* (All fields are mandatory)

DO Name

 

DO Code

 

Personal Information

Select salutation

 

Name of the applicant (Full name)

 

Select agent type

 

Select nationality

 

Select city type

 

Select Category

 

Select gender

 Male    Female  

Select marital status

 

Enter aadhar card number

 

Enter pancard number

 

Mobile number of the candidate

 

Phone number of the candidate

 

Candidate email id

 

What is your date of birth?

 

Password

 

Educational Information

Basic educational qualification

Candidate institute/Board Name

 

Candidate roll number

 

Basic qualification year

 

Additional qualification

 

Select profession type

 

Which language can you read, write and speak?

Read Write Speak
Read Write Speak
Read Write Speak

Address

Is temporary address as a current address?

Current address :

Address 1

 

Address 2

 

Address 3

 

City

 

Pincode

 

State

 

District

 

Permanent address :

Address 1

 

Address 2

 

Address 3

 

City

 

Pincode

 

State

 

District

 

Gaurdian details

Name of the Father/Husband

 

Select father occupation

 

Permanent state

 

Permanent district

 

Permanent city

 

Give name and address of two responsible persons ( not relatives or employees of the Corporation ) for the purpose of reference

Address 1 for reference :

Name

 

Address 1

 

Address 2

 

Address 3

 

City

 

Pincode

 

State

 

District

 

Address 2 for reference :

Name

 

Address 1

 

Address 2

 

Address 3

 

City

 

Pincode

 

State

 

District

 

About exam

Exam language

 

Exam center

 

Upload photo and signature

Upload photo of the applicant

 

Upload signature of the applicant

 

Declaration

 

I agree the User Agreement and Terms & Condition.I agree the User Agreement and Terms & Condition.I agree the User Agreement and Terms & Condition.I agree the User Agreement and Terms & Condition.