Registration

[Note 1: Name as recorded in the matriculation/ Secondary/ Examination Certificate]
[Note 2: Please do not use any prefix such as Shri/ Mr./ Ms./Dr./ Mrs. etc]

[Note: Please don not use any prefix such as Shri/ Mr./Dr. etc]

[Note: Please do not use any prefix such as Smt/ Mrs./Dr. etc]

Yes No
Yes No

[Note: DOB as recorded in the Matriculation/ 10th Standard or equivalent certificate. Where Date of Birth is not available in certificate/mark sheets, issued by concerned Educational Boards, DOB as indicated in School leaving certificate will be considered)] Required Document For Age Proof]

Married Unmarried Divorced Separated

[Note: enter Your E-mail Address which is current and active]

Address:
VIllage/Town/City:
District:
State:
Pincode:
Police Station:
Same as Address of Correspondence
VIllage/Town/City:
District:
State:
Pincode:
Police Station:

[Enter Your Mobile Number without 91 or +91 As. 9999988888]
[Please Note that All the communication from AIWTD will be made on this mobile number only.]