Registration – Pragathy PCB Design Name *Guardian / Parent Name *Email *Confirm Email Address *Mobile *Gender *MaleFemaleOtherAge *Do you belong to Scheduled Tribe *Select any one from the ListYesSub caste *Select any one from the ListAdiyanAranda (Arandan)EravallanHill Pulaya(Mala Pulayan, Kurumba Pulayan, Karavazhi Pulayan, Pamba Pulayan)Irular,IrulanKadar (Wayanad Kadar)Kanikkaran,KanikarKarimpalanKattunayakanKochuvelanKoragaKudiya,MelakudiKurichchan (Kurichiyan)Kurumans (Mullu Kuruman, Mulla Kuruman, Mala Kuruman)Kurumbas (Kurumbar, Kurumban)MahamalasarMalai Arayan (Mala Arayan)Malai PandaranMalai Vedan (Mala Vedan)MalakkuravanMalasarMalayan, Nattu Malayan, Konga Malayan (Excluding the areas comprising the Kasaragod, Kannur, Wayanad and Kozhikode Districts)MavilanMalayarayarMannan (to be spelt in Malayalam script in parenthisis)Muthuvan,Mudugar,MuduvanPalleyan, Palliyan, Paliyar, PalliyaPaniyanUlladan, UllatanUralyMala Vettuvan (in Kasaragod and Kannur Districts)Ten Kurumban, Jenu KurumbanThachenadan, Thachenadan, MoopanCholanaickanMalapanickarVettakurumanAnnual Income in lakhs *Please select an option0 – 10,00010,001 – 50,00050,001 – 1 lakhMore than 1 lakhQualification *Select any one from the ListGraduationPost-GraduationPhDSubject Area *Select any one from the ListScienceEngineeringArtsOtherSpecialisation *Select any one from the ListMathsITComputer ScienceOtherPercentage of marks in Degree *Percentage of marks in 12th *Percentage of Marks 10th *District *Select any one from the ListAlappuzhaErnakulamIdukkiKannurKasaragodKollamKottayamKozhikodeMalappuramPalakkadPathanamthittaThiruvananthapuramThrissurWayanadStreet Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint HelenaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. MartinSt. Pierre & MiquelonSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluU.S. Virgin IslandsUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweI agree that all the information furnished above are true to the best of my knowledge. I will be willing the share necessary documentary evidences / proof for the information furnished above, to the competent authorities, at the time of selection processSubmit