RGUKT - 2023

1. Candidate Details

Candidate's Name *

Gender *

Male

Female

Transgender

Father's Name *

Mother's Name *

Date of Birth * (DD/MM/YYYY)

Aadhaar Number/Passport Number *

Nationality *

Domicile State *

Place of Birth *

Category *

Photo *

Photo (<50kb jpg, jpeg)

Signature (<30kb jpg, jpeg)

Person with Benchmark Disabilities (PBDs)

VH (Visually Handicapped)

HH (Hearing Handicapped)

OH (Orthopedically Handicapped)

Autism, Intellectual Disability, Specific Learning Disablility, Mental Illness and Multiple Disabilities

Ex Service Man *

Yes

No

Meritorious sports person *

Yes

No

2. Address

Communication Address * Pincode *:

Permanent Address *( Same as Communication Address) Pincode *:

Mobile Number *

EMail Id *

3. User Details

Username * (8-16 Charecters)

Username Allows Alphabet and Numbers

Password * (8-12 Charecters)

Password should have atleast One Capital Alphabet, One Number and One Special Character ($@!%*#).

Confirm Password * (8-12 Charecters)