1772, Near UPSIDC, Behatapul Kurshi Road, Lucknow
Post Applied For* :
Examination Center* :
Email ID* :
Comfirm Email ID* :
Candidate's Name* : First Last (As Per 10Th Certificate)
Father's Name* : First Last
Nationality* :
Date of Birth* : Pick a date Pick a date
Category* :
Marital Status* :
Gender* :
Male Female
Mobile Number*
Name* :          
Address Line1* :   Address Line 2* :  
Address Line 3 :   State* :  
City* :   Pin* :  
Academic Record
Academic Level Year of Pass % of Marks Passed / Appearing
10th Class*
Passed Appearing  
10th +2 Class
Passed Appearing  
Graduation / Diploma
Passed Appearing  
Fee Details            
Bank Name* :   Bank Branch Name* :  
Amount in Rs.* :   D.D Number* :  
Attach Scan Copy :          
Photo & Signature            
 If the uploaded Photo & Signature is not loaded in appropriate place, your application is liable to get rejected
• Allowed Photo Size 20KB to 50 KB
• Allowed Signature Size 10 KB to 20KB
Photograph: *    
Signature: *       
I solemnly affirm that the information furnished above is true and correct in all respects. I have not concealed any information. I realize that if any information furnished herein is found to be incorrect or untrue, I shall be liable to Criminal prosecution and also forgo my claim to the seat in examination. Further, that my candidature for Examination/ Selection and admission to the programme is liable to be cancelled at any stage. I agree to abide by the Rules and Regulations of the National Education Commission.*