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NAAI Registration form
* Indicates required question
Name of NGO/Organization if any
Your answer
Name of PwDs Candidate
*
Your answer
Contact No
*
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Alternate No.
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Email ID
*
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Gender
*
Male
Female
Prefer not say
Other:
Date of Birth
*
MM
/
DD
/
YYYY
Age
*
Your answer
Type of Disability
*
Choose
Locomotor Disability
Visual Impairment
Hearing Impairment
Hard of Hearing
Intellectual Disability
Low Vision
Leprosy Cured Persons
Dwarfism
Mental Illness
Autism Spectrum Disorder
Cerebral Palsy
Muscular Dystrophy
Specific Learning Disabilities
Multiple Scelorosis
Speech and Language Disability
Thalassemia
Hemophilia
Sickle Cell Disease
Multiple Disabilities including Deaf Blindness
Acid Attack Victims
Parkinson's Disease
Disability Percentage
*
Your answer
Educational Qualification
*
Your answer
if Other, Then Specify
*
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Parent/Guardian Name
*
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Permanent Address
*
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City of Residence
*
Your answer
State of Residence
*
Choose
Andhra Pradesh
Karnataka
Kerala
Tamil Nadu
Telangana
Age Group
*
10 to 17 Years
18 to 35 Years
For 35 years & above
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