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Registration Form Orientation To Computers For Persons With Vision Immpairment.
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* Indicates required question
First Name
*
Your answer
hxkl
Middle Namehh
Your answer
Last Name
*
Your answer
Gender
*
Male
Female
Date of Birth
*
DD
/
MM
/
YYYY
Mobile Phone
*
Your answer
Mobile 2
Your answer
Email
*
Your answer
Disability Type
*
Totally Blind
Low Vision
Disability Percentage
*
40% and Below
40% - 60%
60% - 80%
80% and Above
Currently Studying
*
Yes
No
Highest Education Qualification
*
10th/SSC
12th/HSC
Below 10th
Diploma
Graduate
ITI
Post Graduate
Combination of the Education
*
10th/SSC
12th/HSC
6th to 9th Standard
B.A (Bachelor of Arts)
B.A.M.S (Bachelor of Ayurvedic Medicine and Surgery)
B.A.S (Bachelor of Applied Sciences)
B.A.S.L.P (Bachelor of Audiology and Speech Language Pathology)
B.Arch (Bachelor of Architecture)
B.B.A (Bachelor of Business Administration)
B. Com
M. A (Master in Arts)
School/College/University
*
Your answer
Address Line 1 (Permanent)
*
Your answer
District (Permanent)
*
Your answer
State (Permanent)
*
Your answer
Country(Permanent)
*
Your answer
Urban/Rural (Permanent)
*
Urban
Rural
Pin code
*
Your answer
Employment Status
*
Unemployed
Employed But Looking
Employed
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