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Programme Name wanted to Register : 76 1521 2526 293738

First KGID Number (HRMS) :

Official Full Name* :

e-Mail Id* :

Mobile Number* :

Gender :

Male FeMale Transgender

Social Category : GENERALSC/ST

Date of Birth :

Present Cadre designation :

Present Working Office Name & Address :

Communication Residential Address :

Contact Person Name (Bengaluru) in case emergency :

Contact Person Number (Bengaluru) in case emergency :

Whether Participant represents Hyderabad Karnataka(371 J) [applicable for KSA&AD , Treasury] :

Yes No

Out of 9 modules how many completed( excluding present nomination) [applicable for KSA&AD ,Treasury] :

I agreed to information given above

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