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Registration Form
Ek Bharat Shrestha Bharat
Email address *
Name *
School Name *
Centre Name
Course Name *
Permanent Address *
Correspondance Address *
Parent Contact No.
Student Contact No. *
Student Photo(Max size 1MB) *
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Student Signature *
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I am interested in attending the training programme under EBSB at Chhatisgarh from the date 18/12/2017 To 25/12/2017 and will take responsibility through the duration of the programme. *
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