Applicant Name	*
Father's Name	*
Date of Birth	Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Qualification	*
IITian	Yes No
Are You Ex Cp Student	Yes No
Division	Select Division JEE/NEET Foundation (VI-X) *
Subject	Select *
Preferred Test city	---Select City--- KOTA ALWAR JAIPUR
Preferred Test Date	Select Test Date
Preferred Job Location 1	---Select Location--- Alwar Ambikapur Bhagalpur Bhavnagar Bhubneswar Bikaner Bilaspur Chennai Delhi Guwahati Gwalior Hamirpur Himatnagar Indore Jaipur Jammu Jamnagar Jodhpur Keonjhar Kishangarh Kolkata Kollam Korba Kota Lucknow Mahendragarh Malkapur Mathura Modasa Mohali Mundra Mysore Patiala Pattukkottai Perambalur Pilani Pune Rajahmundry Rourkela Siliguri Sriharikota Srinagar Thriruvanantpuram Visakhapatnam
Preferred Job Location 2	---Select Location--- Alwar Ambikapur Bhagalpur Bhavnagar Bhubneswar Bikaner Bilaspur Chennai Delhi Guwahati Gwalior Hamirpur Himatnagar Indore Jaipur Jammu Jamnagar Jodhpur Keonjhar Kishangarh Kolkata Kollam Korba Kota Lucknow Mahendragarh Malkapur Mathura Modasa Mohali Mundra Mysore Patiala Pattukkottai Perambalur Pilani Pune Rajahmundry Rourkela Siliguri Sriharikota Srinagar Thriruvanantpuram Visakhapatnam
Address	*
(Shipping) Address2
(Shipping) Address3
City	*
State	---Select--- Andaman and Nicobar Islands Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli Daman and Diu Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Ladakh Ut Lakshadweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Other Pondicherry Punjab Rajasthan Sikkim Talangana Tamil Nadu Tripura Uttar Pradesh Uttarakhand Uttaranchal West Bengal *
District
Pin Code
Mobile No	* Must be 10 digits
Email Id	* InValid Email
Upload Resume File Must be(Doc,Docx)
Online registration charges
For Test Process: Download eCareerPoint App.