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Creation of New e-Mail Account(for individual user)

New e-Mail Account

*First Name :
Middle Name :
*Last Name :
* Date of Birth (DD/MM/YYYY) :
* Designation :
*Ministry/Department :
*Organization/HOD Office :
 
Aadhaar Number :
Emp ID Number :
* Official Address :
City :
* District :
* PIN Code :
* Mobile no :
*Re-Enter Mobile no :
Phone no :
** Preferred Email ID a) : b):
* Alternate Email ID :

* Retirement/Completion of Contract Date :

* Entries are mandatory and need to be filled
** The login ids will be generated based on the guidelines issued under email address policy. A Suffix may be added to make the email id unique across the domain
** Please check the policy: https://mail.nic.in/docs/NIC_Policy_on_format_of_e-mail_Address.pdf

 This is to declare that I have read the terms and conditions and I agree to abide by them.


Signature of Respective Office head/ HOD
Of the Department with date and seal


Signature of the Applicant
with date and seal

The above applicants is employee/Contractual with our department/sub-ordinate office of our department that draw its funds from the consolidate fund of Govt. of M.P.***




***Signature of Nominated Nodal Officer
With date and seal
Name & Designation: _______________
E-mail and Tel._____________________

   



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Last Updated on : 26-06-2015