Mother's Name

Select Male Female Transgender Other Prefer not to say

Select Smart Phone Feature Phone Both None

Who does the phone belong to?

Select Me Father Mother Neighbor Sibling Relative Other

Aadhaar No.

Select Upto Class V Class V Class VIII Class X Class XII Graduate Post-Graduate

Select BiharMadhya PradeshMaharashtraOdishaRajasthanUttar Pradesh

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I agree to be a coach as a part of Pratham's Education for Education initiative

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