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User Agency/Proponent Details Applicant Details: Select

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Parthiban Guru
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0% found this document useful (0 votes)
63 views1 page

User Agency/Proponent Details Applicant Details: Select

Uploaded by

Parthiban Guru
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Ministry of Environment, Forest and Climate Change

Government of India
“Pro Active and Responsive facilitation by Interactive and Virtuous Environmental Singlewindow Hub”

New Registration Form

!Help
All fields marked with * are Mandatory.
* 1. One time registration of User Agency is required on the Portal.
* 2. User Agency can register more than one Applicant (or branch offices) under same name.
* 3. An applicant (with same user id) can submit more than one proposal on the portal.
* 4. Once entered, Email Id of User Agency can not be modified.
Already member? Click here to Log In

User Agency/Proponent Details Applicant Details

User Agency (Head Office) * : First Name * :

Enter First Name


Click here to search User Agency
Middle Name :
State * :

Enter Middle Name


Select

District * : Last Name * :

Select
Enter Last Name
Address * :
Gender * :

Enter User Agency Address


Select

Designation * :

Enter Designation

Address * :
Pincode * :

Enter Pincode

Landmark :

Enter Landmark

Email Address * : State of the Branch/Head Office * :

Select
Enter Email Address Here
District of the Branch/Head Office * :
Landline Telephone No * :

Select

STD Enter Land Line Tehsil of the Branch/Head Office :

Fax No. :
Select

Pincode * :
Code Enter Fax No.

Mobile * : Enter Pincode

Landmark :
+91 Enter 10 digits Mobile No.

Website (if any) : Enter Landmark

Email Address * :

Enter Website Here

Legal Status of User Agency * : Enter Email Address Here

Landline Telephone No * :
Select

Whether any proposal submitted by User agency in past * :


STD Enter Land Line

Select Fax No. :

STD Enter Fax No.

Mobile * :

+91 Enter 10 digits Mobile No.

Security Question * :

Select

Security Answer * :

Enter Security Answer

Enter text string of the image above * :

Please Enter Text String...

SUBMIT

"
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