Name *

E-Mail Address * Official email only for government farms

Farm Name*

Farm Incharge / Owner*

Date of Birth *

Gender*

Contact *

Education

Parentage

Designation / Profession

Annual Farm Income (in Rs.)

Is this a Government Farm? *

State * --Select a State-- Andaman and Nicobar (AN) Andhra Pradesh (AP) Arunachal Pradesh (AR) Assam (AS) Bihar (BR) Chandigarh (CH) Chhattisgarh (CG) Dadra and Nagar Haveli (DN) Daman and Diu (DD) Delhi (DL) Goa (GA) Gujarat (GJ) Haryana (HR) Himachal Pradesh (HP) Jammu and Kashmir (JK) Jharkhand (JH) Karnataka (KA) Kerala (KL) Lakshdweep (LD) Madhya Pradesh (MP) Maharashtra (MH) Manipur (MN) Meghalaya (ML) Mizoram (MZ) Nagaland (NL) Odisha (OD) Puducherry (PY) Punjab (PB) Rajasthan (RJ) Sikkim (SK) Tamil Nadu (TN) Tripura (TR) Uttar Pradesh (UP) Uttarakhand (UK) West Bengal (WB)

District * --Select a District--

Location of the Farm *

Approximate Farm Strength *

Year of Establishment

Upload Farm Photo *

Upload Identification Proof * In case of government farms, please upload a signed and sealed letter from your farm head

Password *

Confirm Password *

Security Question * --Select your secruity question-- What is your mother's maiden name? What is the name of your first pet? What elementary school did you attend? What is the name of the town where you were born? What were the last four digits of your childhood telephone number?

Write your answer. *