BECOME A SOOCHNAPRENUER/ CIRC SAATHI – Digital Community Information Centers in India, DEF

First name *

Last name *

Email *

State

District *

Permanent Residential Address

Phone Number

Qualification *

Gender *

Are you a Person with Disability (PWD)? *

Social Category *

Do you have a center space? *

if yes, please mention the center Address

For center space, please select from the options given *

If own,

If rented,

How many Digital Assets do you need (Please select from the options given)? 1. Laptop/Desktop

Tablets

Do you have a CSC/ e-Governance ID? *

Do you have a Digital Trainers? *