Farmers Academy | Registration Form
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Registration Form for Resource Personnel
Name :
*
Gender :
*
Choose One
Male
Female
Date of birth :
*
Last degree / Diploma :
*
Training/Certificate :
Address :
*
City / District :
*
Select One
Joypurhat
Bogra
Naogaon
Natore
Nawabganj
Pabna
Sirajganj
Rajshahi
Dinajpur
Gaibandha
Kurigram
Lalmonirhat
Nilphamari
Panchagarh
Rangpur
Thakurgaon
Barguna
Barisal
Bhola
Jhalokati
Patuakhali
Pirojpur
Bandarban
Brahmanbaria
Chandpur
Chittagong
Comilla
Cox's Bazar
Feni
Khagrachhari
Lakshmipur
Noakhali
Rangamati
Dhaka
Faridpur
Gazipur
Gopalganj
Jamalpur
Kishoreganj
Madaripur
Manikganj
Munshiganj
Mymensingh
Narayanganj
Netrokona
Rajbari
Shariatpur
Sherpur
Tangail
Narsingdi
Bagerhat
Chuadanga
Jessore
Jhenaida
Khulna
Kushtia
Magura
Meherpur
Narail
Satkhira
Habiganj
Moulvibazar
Sunamganj
Sylhet
Upazilla / Thana :
*
Mobile number :
*
Alternate mobile/Land line number :
Email :
Alternate email :
Identify yourself :
*
Select One
Knowledge professional - Trainer/Teacher/Consultant/Researcher
Public sector extension worker
Private sector employee
Input seller - Retailer/Dealer/Distributor
Procurer - Aratdar/Bapari/Procurement agent/ Contract farmer
Major sector of interest :
*
Select One
Livestock
Poultry
Fisheries
Horticulture and cereal crops
Others
Sub sector of interest :
*
Description of your interest :
User name :
*
Password :
*