Application Form of Distance Education : JAN-2026

Marked with*fields are mandatory
Department and Course Details
Department Name Centre For Distance Learning & Continuing Education (ODL)
Select Programme  Type*
Select Programme *
ABCId and DebId Details
Academic Bank of Credit Id (ABC Id)* Create ABC Id DEB Unique Id * Create DEB Unique Id
Applicant's Details
Applicant Name *


Father's/Husband Name *    Mother's Name*
Date of Birth*
Gender*
Medium*
Blood Group*
Nationality*
Whether domicile of Madhya Pradesh*
Category*
Select Area *
E-mail ID*
Mobile*
(Is your mobile number same as whatsApp No.)
*Please enter active Mobile Number and E-Mail Id for further communication.
Are you PWD (Person with Disability)?*
Are you in Service?*
Identity Proof Id * Identity Proof Id *
Correspondence Address
Address Line 1*
Correspondence Address Line 1 Max. 100 character. 		Address Line 2 *
Correspondence Address Line 2 Max. 100 character.
State*
District*
City*
Pin Code*
Particulars of the Last qualifying examination
Exam Passed* University/Board*
Passing Year*  Previous Enroll No. *
Obtain Marks* Total Marks *
Old (ODL) Student *
Document Forwarding Center Details 
Coordinator Name*
Coordinator Name Mobile No.
Address
Academic qualification
Class Course Roll No Passing Year Obtain Marks Total Marks Percentage Board/ University
10+2/
Polytechnic Diploma*






Attachments tachments
10th Marksheet scan copy: *
(Scan copy in .pdf/.JPG format and size between 100 KB to 300KB)
12th Marksheet scan copy*
(Scan copy in .pdf/.JPG format and size between 100 KB to 300KB)
Upload Photo with Signature
Upload Photo with Signature*
Upload Image
Declaration
सूचना: ऑनलाइन फॉर्म भरने एवं शुल्क भुगतान करने की सुविधा सीधे छात्रों को उपलब्ध कराई गई है। अतः आवेदक स्वयं फॉर्म भरें एवं शुल्क का भुगतान करें। किसी अन्य व्यक्ति या इंटरनेट कैफे से किये गए भुगतान हेतु आवेदक स्वयं जिम्मेदार होंगे।
Captcha*