JAGRATA | An Initiative of South Tripura District Administration

Home/Registration for Jagrata Volunteer

Role *

Mention Role*

Name *

Photo *

Highest Educational Qualification *

Mention Qualification *

Specialization *

Date of Birth *

Blood Group *

Identification Mark

Permanent Address *

Tick if PRTC & Current address are the same

Current Address *

Phone Number *

Emergency Contact Number

Email ID

Father's Name *

Mother's Name *

Other Curriculum Activities (If any)

Married *

Have Children *