VLE Membership Registration | VLE Unity Dhenkanal

Step 1 of 5

Personal & Address Details

20%

1. Personal & Address

2. CSC & Professional

3. Documents

4. Member & Nominee

5. Payment & Review

1 Personal & Address Details (ବ୍ୟକ୍ତିଗତ ଓ ଠିକଣା ବିବରଣୀ)

Please enter your personal details and Dhenkanal location information.

Full Name (ସମ୍ପୂର୍ଣ୍ଣ ନାମ) *

Father / Husband Name *

Date of Birth *

Gender *

Mobile Number *

WhatsApp Number

Email Address

Aadhaar Number

District *

Block / NAC / Municipality *

Gram Panchayat / Ward *

PIN Code *

Full Detailed Address *

2 CSC & Professional Details (କେନ୍ଦ୍ର ଓ ବୃତ୍ତିଗତ ବିବରଣୀ)

Information regarding your digital service kiosk and work experience.

Service Platform *

CSC ID / VLE ID *

Centre Name *

VLE / CSC Experience

Main Digital Services Delivered

Primary Occupation *

Overall Industry Experience

3 Mandatory Document Uploads (ଆବଶ୍ୟକୀୟ ଦସ୍ତାବିଜ୍)

Allowed formats: PDF, JPG, PNG. Maximum 5MB per file.

1. Passport Photo *

2. Aadhaar Card *

3. CSC / VLE Certificate *

4. Character Certificate (ଚରିତ୍ର ପ୍ରମାଣପତ୍ର) *

4 Membership & Nominee Details (ସଦସ୍ୟତା ଓ ଉତ୍ତରାଧିକାରୀ)

Nominee information for association welfare corpus.

Membership Category *

Blood Group *

Nominee Name *

Relationship with Nominee *

5 Payment & Final Review (ଦେୟ ଓ ଚୂଡ଼ାନ୍ତ ଯାଞ୍ଚ)

Scan QR, enter UTR, review details, and submit application.

SCAN TO PAY VIA UPI

₹100.00 7504670234@paytm

12-Digit UPI Ref / UTR Number *

Upload Payment Screenshot / Receipt *

ମୁଁ ଏତଦ୍ୱାରା ଘୋଷଣା କରୁଅଛି ଯେ ଉପରୋକ୍ତ ସମସ୍ତ ବିବରଣୀ ଏବଂ ପ୍ରଦତ୍ତ ଦସ୍ତାବିଜ୍ ସମ୍ପୂର୍ଣ୍ଣ ସତ୍ୟ ଅଟେ।