PERSONAL INFORMATION

Agency Name :*

Agent/AM Code :*

Mobile No. : *

Permanent Address :*

Date of Birth :*

Gender :*

Please selectMaleFemaleOther

Marital Status :*

Please selectUnmarriedMarriedOther

Email id :

Father’s Name :*

Mother's Name :*

Grand Father's Name :

Spouse (Husband/Wife) :

ACADEMIC PROFILE

Level :*

Please selectSLC/SEE

Board/University :*

Please selectNepal Board-SLC/NEB

Division :*

Please selectFirst-1stSecond-2ndThird-3rdABCDEPASS

Year :*

Level :*

Please selectAgriculture+2/PCLBachelorBHMDiplomaEducationEngineeringForestHumanitiesLawManagementMasterMedicalSanskritScienceOther

Board/University :*

Please selectH.S.E.B.-10+2Tribbuvan UniversityPokhara University-BHMPurbanchal UniversityKathmandu UniversityAgriculture and Forestry UniversityJawaharla Neru UniversityBharathiar UniversitySaitama UniversityPanjab Technical UniversityShree Jana Jyoti Higher Secondary School PhosretarBoard of High School & Itermediate Examination, U.P. University of Kerala Mid Westren UniversityOther University

Division :*

Please selectFirst-1stSecond-2ndThird-3rdABCDEPASSRunning

Year :*

Level :*

Please selectAgriculture+2/PCLBachelorBHMDiplomaEducationEngineeringForestHumanitiesLawManagementMasterMedicalSanskritScienceOther

Board/University :*

Please selectH.S.E.B.-10+2Tribbuvan UniversityPokhara University-BHMPurbanchal UniversityKathmandu UniversityAgriculture and Forestry UniversityJawaharla Neru UniversityBharathiar UniversitySaitama UniversityPanjab Technical UniversityShree Jana Jyoti Higher Secondary School PhosretarBoard of High School & Itermediate Examination, U.P. University of Kerala Mid Westren UniversityOther University

Division :*

Please selectFirst-1stSecond-2ndThird-3rdABCDEPASSRunning

Year :*

WORK EXPERIENCE

Note: Upload Size-max.500KB

Agency Photo

Send

This field should be left blank