Fields with * are mandatory

Teacher Photo [JPG,JPEG and PNG Image Only][Max Size 100 KB] *

Name in full (in block letter) *

Father’s Name *

Mother’s Name *

Gender * Please Select Male Female Other

Marital Status * Please Select Married UnMarried

Date Of Birth *

Designation *

MobileNo *

School Type * Please Select Primary Upper Primary Secondary Higher Secondary

District * Please Select Anjaw Capital Complex Changlang Dibang Valley East Kameng East Siang Kamle Kra-Daadi Kurung Kumey Lepa Rada Lohit Longding Lower D / Valley Lower Siang Lower Subansiri Namsai Pakke Kessang Papum Pare Shi Yomi Siang Tawang Tirap Upper Siang Upper Subansiri West Kameng West Siang

Select DDSE for Reporting * Please Select ANJAW Capital complex CHANGLANG DIBANG VALLEY East kameng EAST SIANG Kamle Kra-Daadi KURUNG KUMEY Leparada LOHIT LONGDING LOWER DIBANG VALLEY LOWER SIANG LOWER SUBANSIRI NAMSAI Pakke Kessang PAPUM PARE Shi-Yomi SIANG DISTRICT TAWANG TEST DDSE TIRAP UPPER SIANG UPPER SUBANSIRI WEST KAMENG WEST SIANG

UDISE Code of School

Complete school address with Pin code *[Please fill up without using any Hyphen(-), Colon(:), Bracket(), Slash(/) and Enter button. You can use Alphabets, Numbers, Space, Comma and Dot]

Qualification *[Please fill up without using any Comma (,),Hyphen(-), Colon(:), Bracket(), Slash(/) and Enter button. You can use only alphabets, Space or Dot]*
Click Add More Qualification button to Add more than one Qualification Degrees