dpcomplaint.manipuruniv.ac.in Open in urlscan Pro
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1 forms found in the DOM

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  <div class="form-group has-feedback col-md-12" id="changedrop">
    <select name="user" class="form-control" required="1" id="user" aria-required="true">
      <option value="">--Select User Type--</option>
      <option value="1">Student</option>
      <option value="2">Teacher</option>
      <option value="3">Non-Teaching Staff</option>
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  </div>
  <div class="form-group has-feedback col-md-12">
    <input type="text" id="name" name="name" class="form-control" required="1" placeholder="Name" aria-required="true">
  </div>
  <div class="form-group has-feedback col-md-12">
    <input type="text" id="coname" name="coname" class="form-control" required="1" placeholder="Father's Name/SO/WO/HO" aria-required="true">
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  <div class="form-group has-feedback col-md-6">
    <select name="gender" id="gender" class="form-control" required="1" aria-required="true">
      <option value="" selected="selected">--Select Gender--</option>
      <option value="M">Male</option>
      <option value="F">Female</option>
      <option value="T">Third-Gender</option>
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  </div>
  <div class="form-group has-feedback col-md-6">
    <select name="category" id="category" class="form-control" required="1" aria-required="true">
      <option value="" selected="selected">--Select Category--</option>
      <option value="SC">SC</option>
      <option value="ST">ST</option>
      <option value="OBC">OBC</option>
    </select>
  </div>
  <div class="form-group has-feedback col-md-12">
    <input type="text" id="address1" name="address1" class="form-control" required="1" placeholder="Address1" aria-required="true">
  </div>
  <div class="form-group has-feedback col-md-12">
    <input type="text" id="address2" name="address2" class="form-control" placeholder="Address2">
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  <div class="form-group has-feedback col-md-6">
    <select name="state" class="form-control state" required="1" id="state" value="" aria-required="true">
      <option value="" selected="selected">--Select State--</option>
      <option value="AN">Andaman &amp; Nicobar</option>
      <option value="AP">Andhra Pradesh</option>
      <option value="ARP">Arunachal Pradesh</option>
      <option value="AS">Assam</option>
      <option value="BH">Bihar</option>
      <option value="CH">Chandigarh</option>
      <option value="CG">Chhattisgarh</option>
      <option value="DN">Dadra &amp; Nagar Haveli</option>
      <option value="DD">Daman and Diu</option>
      <option value="DL">Delhi</option>
      <option value="GA">Goa</option>
      <option value="GJ">Gujarat</option>
      <option value="HR">Haryana</option>
      <option value="HP">Himachal Pradesh</option>
      <option value="JK">Jammu &amp; Kashmir</option>
      <option value="JH">Jharkhand</option>
      <option value="KA">Karnataka</option>
      <option value="KL">Kerala</option>
      <option value="LX">Lakshadweep</option>
      <option value="MP">Madhya Pradesh</option>
      <option value="MH">Maharashtra</option>
      <option value="MN">Manipur</option>
      <option value="MG">Meghalaya</option>
      <option value="MZ">Mizoram</option>
      <option value="NG">Nagaland</option>
      <option value="OR">Odisha</option>
      <option value="PC">Pudducherry</option>
      <option value="PB">Punjab</option>
      <option value="RJ">Rajasthan</option>
      <option value="SK">Sikkim</option>
      <option value="TN">Tamil Nadu</option>
      <option value="TG">Telangana</option>
      <option value="TR">Tripura</option>
      <option value="UP">Uttar Pradesh</option>
      <option value="UK">Uttarakhand</option>
      <option value="WB">West Bengal</option>
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  </div>
  <div class="form-group has-feedback col-md-6">
    <input type="text" id="pincode" name="pincode" class="form-control" required="1" maxlength="6" placeholder="Pin Code" aria-required="true">
  </div>
  <div class="form-group has-feedback col-md-6">
    <input type="text" name="mobile" class="form-control" required="1" id="mobile" placeholder="Mobile" maxlength="10" aria-required="true">
  </div>
  <div class="form-group has-feedback col-md-6">
    <input type="email" name="email" class="form-control" required="1" id="email" placeholder="Email" aria-required="true">
  </div>
  <div class="form-group has-feedback col-md-12">
    <input type="text" id="department" name="department" class="form-control" required="1" placeholder="Department/Section" aria-required="true">
  </div>
  <div class="form-group has-feedback col-md-6">
    <input type="text" id="designation" name="designation" class="form-control" required="1" placeholder="Designation" aria-required="true">
  </div>
  <div class="form-group has-feedback col-md-6">
    <input type="text" id="idnumber" name="idnumber" class="form-control" required="1" placeholder="ID Number" aria-required="true">
  </div>
  <div id="student_gi" style="display:none;">
    <div class="form-group has-feedback col-md-6">
      <input type="text" id="regno" name="regno" class="form-control" required="1" placeholder="Registration Number" aria-required="true">
    </div>
    <div class="form-group has-feedback col-md-6">
      <input type="text" id="semester" name="semester" class="form-control" required="1" placeholder="Semester" aria-required="true">
    </div>
    <div class="form-group has-feedback col-md-6">
      <input type="text" id="rollno" name="rollno" class="form-control" required="1" placeholder="Roll No" aria-required="true">
    </div>
  </div>
  <br>
  <div class="form-group has-feedback col-md-6">
    <label>Upload your scanned ID card</label>
  </div>
  <div class="form-group has-feedback col-md-6">
    <input type="file" id="signature" name="signature" required="" aria-required="true">
  </div>
  <div class="form-group has-feedback col-md-12"> Complaint:<textarea name="complaint" id="complaint" class="form-control" rows="5" required="1" placeholder="" aria-required="true"> </textarea>
  </div>
  <div class="form-group has-feedback col-md-12">
    <label></label>
  </div>
  <div class="form-group has-feedback col-md-12">
    <div class="col-md-6 no-padding">
      <input type="text" id="letters_code" name="letters_code" class="form-control" required="1" placeholder="Captcha" aria-required="true">
    </div>
    <div class="col-md-3">
      <span class="image"><img style="border:1px solid #e6e6e6; border-radius:3px; max-width:100%;" src="captcha_code_file.php?rand=991512474" id="captchaimg"></span>
    </div>
    <div class="col-md-3 no-padding">
      <small style="width:100%; display:block;">Can't read the image? click <a href="javascript: refreshCaptcha();">here</a> to refresh</small>
    </div>
  </div>
  <div class="form-group has-feedback col-md-12">
    <p align="justify">
      <input type="checkbox" required="1" name="checkok" value="true" aria-required="true">
      <b><i> I certify that the information given above is true to the best of my knowledge. If any of the information is found to be false, I understand that I may be penalized for the same.</i></b>
    </p>
  </div>
  <div class="social-auth-links text-center">
    <button type="submit" name="myButton" class="btn btn-success btn-block btn-flat" onclick="">CONFIRM</button>
  </div>
</form>

Text Content

 * Contact Us


D.P. Complaint | Form
 * The M.U. Discrimination Prevention Committee will look into the complaints of
   discrimination received from SC /ST /OBC Students /Teachers /Non-Teaching
   Staff.
 * All the Fields are Mandatory except - Address2, Registration number.
 * Scan Image of ID card should be in JPG or JPEG format.
 * Scan Image Upload Size should not exceed 2 MB.
 * Your complaint will be process only when you verify the OTP with your Email.

Discrimination Prevention Complaint Registration

--Select User Type-- Student Teacher Non-Teaching Staff


--Select Gender-- Male Female Third-Gender
--Select Category-- SC ST OBC


--Select State-- Andaman & Nicobar Andhra Pradesh Arunachal Pradesh Assam Bihar
Chandigarh Chhattisgarh Dadra & Nagar Haveli Daman and Diu Delhi Goa Gujarat
Haryana Himachal Pradesh Jammu & Kashmir Jharkhand Karnataka Kerala Lakshadweep
Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Pudducherry
Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand
West Bengal








Upload your scanned ID card

Complaint:

Can't read the image? click here to refresh

I certify that the information given above is true to the best of my knowledge.
If any of the information is found to be false, I understand that I may be
penalized for the same.

CONFIRM
About Us. | Contact Us.


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