APPLICATION FORM FOR ADMISSION

1. Name of the Course    
2. Course Code  
3... Duration (Weeks)   
4.  Period : from - To  
5. Name of the Applicant ( in block letters)  
6. Father's/Husband's  name  
7. Date of Birth  
8. Whether SC/ST/PH  

 Mailing Address :

 

 

 

Academic Qualification (S.S.L.C./ + 2 / B.Sc./B.A../B.Com.)

S.No Examination Passed    Year    %age of marks   Subjects
         
         
         
         

Technical Qualifications ( B.E./Diploma/ NAC/ NTC)

S.No  Examination Passed    Branch/Trade   %age of Marks    Issuing  Authority               Year
           
           
           
           

.                                                                                                                  

Experience (including present posting)

S. No. Name of the Employer Nature of  Job Designation From To

 

                                                                                       Signature of the Applicant

Place:

Date:

                        ( for sponsoring authority only)

CERTIFIED THAT THE ABOVE CANDIDATE IS EMPLOYED BY US AND THE QUALIFICATION AND EXPERIENCE STATED BY HIM/HER HAVE BEEN VERIFIED AND FOUND CORRECT.

 

DATE :                                                                            Signature of sponsoring  Authority

                                                                                        Office   Seal

                                                                                        Phone No..

 

Name & address of the establishment is to be mentioned : a copy of S.S.I. registration Certificate is to be attached in case of candidates who apply through Small Scale Industries.

 

Note- Rs.15/- shall be charged for each application as registration fee at the time of submission of application form for registration . Payment may be made through  Indian Postal Order/ Demand Draft drawn in favour of  Director / Principal (as mentioned in the contact address) of the institute . .

Application form without registration  fee will not be accepted .