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Existing ALC

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School/College

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Alternate Mobile Number*
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Taluka Name*
Village Name*

Username*
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Address*

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Classes

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Teacher Name*

Medium*
Area*

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Alternate Mobile Number*
District Name*

Taluka Name*
Village Name*

Username*
Password*

Address*

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Individual

Name of Student*
Name of School*

School Medium*
Area*

Email ID*
Mobile Number*

Alternate Mobile Number*
District Name*

Taluka Name*
Village Name*

Username*
Password*

Address*

GST No.
PAN No.

Referral Code

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