Garlic Seed Production Programme
Kissan Gurukul Pvt. Limited - Registration Form
Admin Login
Section 1 – Registration Details
Registration Date
Registration Number
Name of Field Officer
Field Officer Mobile Number
Section 2 – Farmer Details
Farmer's Full Name
Father's Name
Mother's Name
Date of Birth
Gender
Male
Female
Other
Mobile Number
Alternate Mobile Number
Aadhaar Number
PAN Number
Education
-- Select Education --
Illiterate
Primary
Middle
Secondary
Senior Secondary
Graduate
Post Graduate
Agriculture Graduate
Diploma
Other
Section 3 – Address
Village
Gram Panchayat
Tehsil
District
State
PIN Code
Section 4 – Land Details
Total Land Holding (Acres)
Owned Land (Acres)
Leased Land (Acres)
Irrigated Land (Acres)
Non-Irrigated Land (Acres)
Irrigation Source
Canal
Tube Well
Bore Well
Drip
Sprinkler
Rainfed
Other
Section 5 – GPS & Farm Location
GPS Latitude
GPS Longitude
Google Maps Location Link
Nearest Mandi
Distance from Mandi (KM)
Section 6 – Garlic Project Details
Area for Garlic Seed Production (Acres)
Garlic Variety
Proposed Sowing Date
Expected Harvest Date
Labour Availability
Yes
No
Storage Facility Available
Yes
No
Section 7 – Cropping Pattern
Current Crop
Current Crop Area (Acres)
Current Crop Expected Production
Last Crop
Last Crop Area (Acres)
Last Crop Production
Previous Crop
Previous Crop Area (Acres)
Previous Crop Production
Section 8 – Crop Available for Sale
Crop Name
Quantity Available
Expected Selling Month
Section 9 – Livestock
Number of Cows
Number of Buffaloes
Number of Goats
Number of Sheep
Number of Poultry Birds
Daily Milk Production (Litres)
Milk Used For
Self Consumption
Sale
Both
Milk Buyer Name
Section 10 – Financial Details
Kisan Credit Card (KCC)
Yes
No
KCC Limit (₹)
Crop Loan
Yes
No
Bank Name
Outstanding Loan Amount (₹)
Other Loans
Section 11 – FPO/FPC Details
Member of any FPO/FPC
Yes
No
Name of FPO/FPC
Since Which Year
Section 12 – Government Schemes
PM-KISAN Beneficiary
Yes
No
Soil Health Card
Yes
No
Crop Insurance
Yes
No
e-NAM Registration
Yes
No
Farmer ID Available
Yes
No
Farmer ID Number
Section 13 – Farm Infrastructure
Available Equipment
Tractor
Rotavator
Seed Drill
Cultivator
Sprayer
Reaper
Thresher
Power Tiller
Solar Pump
Drip Irrigation
Mulching
Cold Storage
Storage Godown
Section 14 – Photos & Documents
Upload Farmer Photograph
Upload Aadhaar Card
Upload PAN Card
Upload Land Record (Jamabandi/Fard)
Upload Farm Photograph
Upload GPS Screenshot
Section 15 – Declaration
I declare that the information provided by me is true and correct.
I agree to participate in the Garlic Seed Production Programme of Kissan Gurukul Pvt. Ltd. and permit the company to use my farm data, GPS location, photographs, and crop details for project implementation and market linkage.
Farmer Signature (Name or Upload Note)
Remarks
Submit Registration