Pre-Registration Form

Name

First name

Last Name

Email

Mobile Number

State / District

- None -Andaman and Nico.In.NicobarNorth And Middle AndamanSouth AndamanAndhra PradeshAnantapurChittoorEast GodavariGunturKadapaKrishnaKurnoolNellorePrakasamSrikakulamVisakhapatnamVizianagaramWest GodavariArunachal PradeshChanglangDibang ValleyEast KamengEast SiangKurung KumeyLohitLower Dibang ValleyLower SubansiriNAPapum PareTawangTirapUpper Dibang ValleyUpper SiangUpper SubansiriWest KamengWest SiangAssamBAKSABARPETABISWANATHBONGAIGAONCACHARCHIRANGDARRANGDHEMAJIDHUBRIDIBRUGARHDIMA HASSO - NORTH CACHAR HILLEAST KARBIANGLONGGOALPARAGOLAGHATHAILAKANDIHOJAIJORHATKAMRUPKAMRUP METROPOLITANKARBI ANGLONGKARIMGANJKOKRAJHARLAKHIMPURMAJULIMARIGAONNAGAONNALBARISIBSAGARSONAPURSONITPURTINSUKIAUDALGURIWEST KARBIANGLONGBiharARARIAARWALAURANGABADBANKABEGUSARAIBHAGALPURBHOJPURBUXARDARBHANGADEOGHAREAST CHAMPARANGAYAGOPALGANJJAMUIJEHANABADKAIMUR BHABUAKATIHARKHAGARIAKISHANGANJLAKHISARAIMADHEPURAMADHUBANIMUNGERMUZAFFARPURNANALANDANAWADAPatnaPURNIAROHTASSAHARSASAMASTIPURSARANSHEIKHPURASHEOHARSITAMARHISIWANSUPAULVAISHALIWEST CHAMPARANChandigarhCHANDIGHARMOHALIChattisgarhBALODBALOD BAZERBALRAMPURBastarBEMETARABijapur(CGH)BILASPURCGHDantewadaDHAMTARIDURGGARIABANDJagdalpurJANJGIRCHAMPAJASPURKankerKAWARDHAKONDAGAONKORBAKORIYAMAHASAMUNDMUNGELINarayanpurRAIGARHRAIPURRAJNANDGAONSUKMASURAJPURSURGUJADadra and Nagar Hav.DADRA NAGAR HAVELIDaman and DiuDAMANDIUDelhiCENTRAL DELHIEAST DELHINEW DELHINORTH DELHINORTH EAST DELHINORTH WEST DELHISHAHDARASOUTH DELHISOUTH EAST DELHISOUTH WEST DELHIWEST DELHIGoaNORTH GOASOUTH GOAGujaratAHMEDABADAMRELIANANDARAVALLIBANASKANTHABHARUCHBHAVNAGARBOTABChhotaudepurDAHODDANGSDEVBHOOMI DWERKAGANDHI NAGARGIR SOMNATHJAMNAGARJUNAGADHKACHCHHKHEDAMAHESANAMAHISAGARMORBINANARMADANAVSARIPANCH MAHALSPATANPORBANDARRAJKOTSABARKANTHASURATSURENDRA NAGARTAPIVADODARAVALSADHaryanaAMBALABHIWANICHARKHI DADRIFARIDABADFATEHABADGURGAONHISARJHAJJARJINDKAITHALKARNALKURUKSHETRAMAHENDRAGARHMEWATPALWALPANCHKULAPANIPATREWARIROHTAKSIRSASONIPATYAMUNANAGARHimachal PradeshBILASPUR HPCHAMBAHAMIRPURHPKANGRAKINNAURKULLULAHUL SPITIMANDINASHIMLASIRMAURSOLANUNAJammu and KashmirANANTHNAGBANDIPURBaramullaBUDGAMDODAGANDERBALJAMMUKargilKATHUAKishtwarKULGAMKupwaraLehPOONCHPULWAMARAJAURIRAMBANREASISAMBASHOPIANSRINAGARUDHAMPURJharkhandBOKAROCHATRADEOGHARDHANBADDUMKAEAST SINGHBHUMGARHWAGIRIDHGODDAGUMLAHAZARIBAGHazaribaghJAMTARAKHUNTIKODERMALATEHARLOHARDAGAPAKURPALAMAURamgarhRANCHISAHIBGANJSERAIKELAKHARSAWANSIMDEGAWEST SINGHBHUMKarnatakaArsikereAthaniBAGALKOTBailhongalBELAGAVIBELLARYBENGALURUBENGALURU RURALBidarBIJAPUR(KAR)ChamrajnagarCHICKMAGALURCHIKKABALLAPURCHITRADURGADakshina KannadaDAVANGEREDharwadGADAGGulbargaHanagoduHASSANHAVERIHubballiHunsurJamkhandiJoidaKALABURAGIKalghatgiKodaguKOLARKollegalKOPPALKundgolMadikeriMandyaMysuruNanjangudRAICHURRAMANAGARRamdurgSAGARSaraswathipuramSHIVAMOGGASiddapurTUMAKURUUDUPIUTTARA KANNADAYADGIRKeralaALAPPUZHAERNAKULAMIDUKKIKANNURKASARGODKOLLAMKOTTAYAMKOZHIKODEMALAPPURAMPALAKKADPATHANAMTHITTATHIRUVANANTHAPURAMTHRISSURWAYANADLakshadweepLakshadweepMadhya PradeshAGAR MALWAALIRAJPURANUPPURASHOK NAGARBALAGHATBARWANIBETULBHINDBHOPALBURHANPURCHHATARPURCHHINDWARADAMOHDATIADEWASDHARDINDORIGUNAGWALIORHARDAHOSHANGABADINDOREJABALPURJHABUAKATNIKHANDWAKHARGONEMANDLAMANDSAURMORENANARSINGHPURNEEMUCHNIVADIPANNARAISENRAJGARHRATLAMREWASAGARSATNASEHORESEONISHAHDOLSHAJAPURSHEOPURSHIVPURISIDHISINGRAULITIKAMGARHUJJAINUMARIAVIDISHAMaharashtraAhmed NagarAKOLAAMRAVATIAURANGABADBEEDBHANDARABHUSAWALBULDHANACHANDRAPURDHULEGadchiroliGONDIAHINGOLIJALGAONJALNAKolhapurLATURMalegaonMirajMUMBAIMUMBAI SUBURBANNAGPURNANDEDNANDURBARNASHIKOSMANABADPALGHARPARBHANIPUNERAIGARH(MH)RATNAGIRISangliSATARAShrirampurSINDHUDURGSOLAPURTHANEWARDHAWASHIMYavatmalManipurBishnupurChandelChurachandpurImphalImphal EastImphal WestJiribamNASenapatiTamenglongTengnoupalTHANLONThoubalUkhrulMeghalayaEast Garo HillsEast Jaintia HillsEast Khasi HillsNorth Garo HillsRi BhoiSouth Garo HillsSouth West Garo HillsSouth West Khasi HillsWest Garo HillsWest Jaintia HillsWest Khasi HillsMizoramAizawlChamphaiKolasibLawngtlaiLungleiMammitNASaihaSerchhipNagalandDimapurKiphireKohimaLonglengMokokchungMonNAPerenPhekTuensangWokhaZunhebottoOdishaANGULBALANGIRBALESWARBARGARHBHADRAKBOUDHCUTTACKDEBAGARHDHENKANALGAJAPATIGANJAMJAGATSINGHAPURJAJAPURJHARSUGUDAKALAHANDIKANDHAMALKENDRAPARAKENDUJHARKHORDAKORAPUTMALKANGIRIMAYURBHANJNABARANGAPURNAYAGARHNUAPADAPURIRAYAGADASAMBALPURSONAPURSUNDERGARHPondicherryKARAIKALMAHEPONDICHERRYVILLUPURAMYANAMPunjabAMRITSARBARNALABATHINDACHANDIGHARFARIDKOTFATEHGARH SAHIBFAZILKAFIROZPURGURDASPURHOSHIARPURJALANDHARKAPURTHALALUDHIANAMANSAMOGAMOHALIMUKTSARNAWANSHAHRPATHANKOTPATIALAROPARSANGRURTARN TARANRajasthanAJMERALWARBANSWARABARANBARMERBHARATPURBHILWARABIKANERBUNDICHITTORGARHCHURUDAUSADHOLPURDUNGARPURHANUMANGARHJAIPURJAISALMERJALORJHALAWARJHUJHUNUJODHPURKARAULIKOTANAGAURPALIPRATAPGHARRAJSAMANDSAWAI MADHOPURSIKARSIROHISRI GANGANAGARTONKUDAIPURSikkimDimapurEAST SIKKIMNORTH SIKKIMSOUTH SIKKIMWEST SIKKIMTamil NaduARIYALURChengalpattuCHENNAICOIMBATORECUDDALOREDHARMAPURIDINDIGULERODEKallakurichiKANCHIPURAMKANYAKUMARIKARURKRISHNAGIRIMADURAIMayiladuthuraiNAGAPATTINAMNAMAKKALNILGIRISPERAMBALURPUDUKKOTTAIRAMANATHAPURAMRanipetSALEMSIVAGANGATenkasaiTHANJAVURTHENITIRUCHIRAPPALLITIRUNELVELITirupatturTIRUPPURTIRUVALLURTIRUVANNAMALAITIRUVARURTUTICORINVELLOREVILLUPURAMVIRUDHUNAGARTelanganaADILABADBHADRACHALAMBHONGIRBHUPALPALLIGADWALHanamkondaHYDERABADJAGTIALJangaonJAYASHANKARK.V.RangareddyKAMAREDDYKARIM NAGARKHAMMAMKOTHAGUDEMKOTHAGUDEM COLLSMAHABUB NAGARMahabubabadMAHABUBNagarMANCHERIALMEDAKNAGAR KURNOOLNALGONDANIRMALNIZAMABADParkalPEDDAPALLIRanga ReddyRANGAREDDYSANGAREDDYSecunderabadSIDDIPETSIRCILLASTN. JADCHERLASURYAPETTrimulgherryVIKARABADWANAPARTHYWarangalWarangal RuralZAHEERABADTripuraDhalaiGomatiKhowaiNorth TripuraSepahijalaSouth TripuraUnakotiWest TripuraUttar PradeshAGRAALIGARHAMBEDKAR NAGARAMETHIAMROHAAURAIYAAYODHYAAZAMGARHBAGPATBAHRAICHBALLIABALRAMPURBANDABARABANKIBAREILLYBASTIBIJNORBUDAUNBULANDSHAHRCHANDAULICHITRAKOOTDEORIAETAHETAWAHFARRUKHABADFATEHPURFIROZABADGAUTAM BUDDHA NAGARGHAZIABADGHAZIPURGONDAGORAKHPURHAMIRPURHAPURHARDOIHARIDWARHATHRASJALAUNJAUNPURJHANSIKANNAUJKANPUR DEHATKANPUR NAGARKASGANJKAUSHAMBIKHERIKUSHINAGARLALITPURLUCKNOWMAHARAJGANJMAHOBAMAHRAJGANJMAINPURIMATHURAMAUMEERUTMIRZAPURMORADABADMUZAFFARNAGARPILIBHITPRATAPGARHPRAYAGRAJRAEBARELIRAMPURSAHARANPURSAMBHALSANT KABIR NAGARSANT RAVIDAS NAGARSHAHJAHANPURSHAMLISHRAWASTISIDDHARTHNAGARSITAPURSONBHADRASULTANPURUNNAOVARANASIUttarakhandALMORABAGESHWARCHAMOLICHAMPAWATDEHRADUNHARIDWARNAINITALPAURI GARHWALPITHORAGARHRUDRAPRAYAGTEHRI GARHWALUDHAM SINGH NAGARUTTARKASHIWest BengalALIPURDUARBANKURABIRBHUMCOOCH BEHARDARJILINGEAST BARDWANEAST MIDNAPOREHOOGHLYHOWRAHJALPAIGURIJHARGRAMKalimpongKOLKATAMALDAMEDINIPURMURSHIDABADNADIANORTH 24 PARGANASNORTH DINAJPURPaschim BardhamanPort BlairPURULIYASOUTH 24 PARGANASSOUTH DINAJPURWEST BARDWANWEST MIDNAPORE

City

Pincode

Type of Request

HB (hard bound) - Rs.500

HB Quanitity

PB (paper back) - Rs.300

PB Quantity

Payment

Total Amount: 800 Update

Yes, I have completed the payment.

Payment ID

Kindly enter the Payment ID/Transaction ID of the payment

Submit