e-Rojgar Card Form

ESSC ID card (e-Rojgar Card) will be provided. 2. Discount on various paid conferences which will be organized by whole ESSC body. 3. Opportunity to participate in networking events. 4. Listing in membership directory (same as before we were providing) 5. Discount in ESSC academy and in its various courses Scholarship Opportunity. 6. Participation in different educational events (Including Career Counseling) 7. Student members can put their signature as a candidate Member – ESSC as their signature on their Gmail account and can put their designation as a candidate member – ESSC on their social networking sites.

REGISTRATION APPLICATION FORM FOR COURSE
1. Registration Details / पंजीयन का विवरण * अनिवार्य फिल्डस (Mandatory fields)
Applicant's full name / आवेदक का पूरा नाम *	Mr./श्री Ms./सुश्री ( Full name as per the highest / latest qualification certificate or legal certificate )
Father's Name / पिता का नाम *	Mr./श्री ( Full Name As Per Educational/Legal Certificate )
Mother's Name / माता का नाम *	Mrs./श्रीमती ( Full Name As Per Educational/Legal Certificate )
Gender / लिंग *	Male Female
Date of Birth / जन्म दिनांक * (dd-Mon-yyyy)	Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Month 1 2 3 4 5 6 7 8 9 10 11 12 / Year 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 ( As per high school certificate in 'dd-Mon-yyyy' format. i.e. '01-Jan-1990' )
Category / वर्ग *	--Select One-- General / सामान्य Scheduled Caste / अनुसूचित जाति Scheduled Tribe / अनुसूचित जनजाति Other Backward Class / अन्य पिछड़ा वर्ग Economically Weaker Section / आर्थिक रूप से कमजोर वर्ग
Married Status / वैवाहिक स्थिति *	--Select One-- Single / अविवाहित Married / विवाहित Divorced / तलाकशुदा Widowed / विधवा / विधुर
2. Contact Details / संपर्क विवरण
Phone with STD Code/ दूरभाष एस टी डी कोड सहित
Mobile Number / मोबाइल नंबर *
Email Address / ईमेल पता	(e.g.abc@yahoo.com)
3. Address Details / स्थायी पता विवरण
Address Line1/पता पंक्ति 1 *
Address Line2/पता पंक्ति 2
Block /ब्लाक *
Panchat/Ward/पंचायत/वार्ड*
Country	-Select-AndorraUnited Arab EmiratesAfghanistanAntigua and BarbudaAnguillaAlbaniaArmeniaAngolaAntarcticaArgentinaAmerican SamoaAustriaAustraliaArubaAland IslandsAzerbaijanBosnia and HerzegovinaBarbadosBangladeshBelgiumBurkina FasoBulgariaBahrainBurundiBeninSaint BarthelemyBermudaBruneiBoliviaBonaire, Saint Eustatius and Saba BrazilBahamasBhutanBouvet IslandBotswanaBelarusBelizeCanadaCocos IslandsDemocratic Republic of the CongoCentral African RepublicRepublic of the CongoSwitzerlandIvory CoastCook IslandsChileCameroonChinaColombiaCosta RicaCubaCape VerdeCuracaoChristmas IslandCyprusCzech RepublicGermanyDjiboutiDenmarkDominicaDominican RepublicAlgeriaEcuadorEstoniaEgyptWestern SaharaEritreaSpainEthiopiaFinlandFijiFalkland IslandsMicronesiaFaroe IslandsFranceGabonUnited KingdomGrenadaGeorgiaFrench GuianaGuernseyGhanaGibraltarGreenlandGambiaGuineaGuadeloupeEquatorial GuineaGreeceSouth Georgia and the South Sandwich IslandsGuatemalaGuamGuinea-BissauGuyanaHong KongHeard Island and McDonald IslandsHondurasCroatiaHaitiHungaryIndonesiaIrelandIsraelIsle of ManIndiaBritish Indian Ocean TerritoryIraqIranIcelandItalyJerseyJamaicaJordanJapanKenyaKyrgyzstanCambodiaKiribatiComorosSaint Kitts and NevisNorth KoreaSouth KoreaKosovoKuwaitCayman IslandsKazakhstanLaosLebanonSaint LuciaLiechtensteinSri LankaLiberiaLesothoLithuaniaLuxembourgLatviaLibyaMoroccoMonacoMoldovaMontenegroSaint MartinMadagascarMarshall IslandsMacedoniaMaliMyanmarMongoliaMacaoNorthern Mariana IslandsMartiniqueMauritaniaMontserratMaltaMauritiusMaldivesMalawiMexicoMalaysiaMozambiqueNamibiaNew CaledoniaNigerNorfolk IslandNigeriaNicaraguaNetherlandsNorwayNepalNauruNiueNew ZealandOmanPanamaPeruFrench PolynesiaPapua New GuineaPhilippinesPakistanPolandSaint Pierre and MiquelonPitcairnPuerto RicoPalestinian TerritoryPortugalPalauParaguayQatarReunionRomaniaSerbiaRussiaRwandaSaudi ArabiaSolomon IslandsSeychellesSudanSouth SudanSwedenSingaporeSaint HelenaSloveniaSvalbard and Jan MayenSlovakiaSierra LeoneSan MarinoSenegalSomaliaSurinameSao Tome and PrincipeEl SalvadorSint MaartenSyriaSwazilandTurks and Caicos IslandsChadFrench Southern TerritoriesTogoThailandTajikistanTokelauEast TimorTurkmenistanTunisiaTongaTurkeyTrinidad and TobagoTuvaluTaiwanTanzaniaUkraineUgandaUnited States Minor Outlying IslandsUnited StatesUruguayUzbekistanVaticanSaint Vincent and the GrenadinesVenezuelaBritish Virgin IslandsU.S. Virgin IslandsVietnamVanuatuWallis and FutunaSamoaYemenMayotteSouth AfricaZambiaZimbabweSerbia and MontenegroNetherlands Antilles
State / राज्य *
District / जिला *
Pin Code / पिन कोड *
4. Educational / Qualification Details / शैक्षिक / योग्यता का विवरण
SL.No./क्र.सं. Qualification/ योग्यता Board/University/ बोर्ड / विश्वविद्यालय Passing Year/ पास वर्ष Marks/ अंक Percentage/ प्रतिशत 1. High School/ उच्च विद्यालय   2. Intermediate/ इंटरमीडिएट 3. Graduation/ स्नातक 4. Post Graduation/ पोस्ट ग्रेजुएशन 5. BTC/ बीटीसी 6. B.Ed/ch.,M. 7. NTT/ एनटीटी 8. Other/ अन्य
5. Identification Details / पहचान की सूचना
Aadhar Card Number (if) / आधार कार्ड संख्या (यदि हो तो)
6. Fee शुल्क	Select Option Rs. 307 for 3 Years  (Normal Member) Rs. 407 for 5 Years (Normal Member) Rs. 1957 for 3 Years (Executive Member)
7.Upload Photo / फोटो अपलोड करें *	( JPG,JPEG,GIF,PNG image with size upto 50 KB )
8. Declaration / घोषणा (यदि हाँ तो बॉक्स ( ) पर क्लिक ( ) करें)
I here by declare that all the information I have mentioned in the online application form for ESSC is true to my knowledge and belief. I also agree and will always abide by the rules and regulations of the ESSC and all the rules and decisions of the organization. I am aware that if any type of statement given above is found to be fales, my eligibility will be deemed to have expired before or after the appointment, apart from any other action which is deemed to be appropriate. Further I also understand that the organization will not be responsible for my loss due to any kind. मैं घोषणा करता हूं कि ब्यौरे ईएसएससी के ऑनलाइन आवेदन पत्र में मेरे द्वारा प्रस्तुत अपने ज्ञान और विश्वास के अनुसार सत्य हैं। मैं नियमों और किसी भी कार्रवाई के बारे में ईएसएससी के निर्णय के पालन करने के लिए सहमत हूं । मेरी किसी प्रकार की क्षति के लिए ईएसएससी उत्तरदायी नहीं होगा।
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