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Photo: Application For

This document is an application form requesting personal information such as name, date of birth, gender, category, contact details, address, education level, identification documentation number, and employment objective. The applicant declares that all information provided is true and complete. The form notes that all fields marked with an asterisk are mandatory to complete the application.

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jeetendra kumar
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50 views1 page

Photo: Application For

This document is an application form requesting personal information such as name, date of birth, gender, category, contact details, address, education level, identification documentation number, and employment objective. The applicant declares that all information provided is true and complete. The form notes that all fields marked with an asterisk are mandatory to complete the application.

Uploaded by

jeetendra kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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_____________________________________________________________________________________________

Application for ---------------------------------------------------------------------

Photo
PHOTO*

1* First Name------------------------------------Middle Name-----------------------------Last Name------------------------------

2* Father First Name .......Middle Name----------------------------Last Name-------------------------------

3* Date of Birth(in the form of Date/Monthe/Year)

4* Gender ( Male/Female).. 5* Category ( SC/ST/OBC)---------------------------

6 Fee deposited ( If any) ....................................................

7* Whether Physically handicapped-------------------------------------------------------------------------------------------------

8* Whether Minority /(Muslim/Christian/Sikh/ Parasi /Budhist) .......................................

9* Highest Education ..................................................................

10* Identity documentation With No. ...............................................

11* Mobile No. ..................................12 Phone No ..........................

13* District .........................................14* City ..........................

15* Address -------------------------------------------------------------------------------------------------------------------------------

------------------------------------------------------------------------------------------------------------------------------

16 PIN--------------------------------- 17 E-mail-------------------------------------------------------------

18* Trainees Objective (Self/Wage/Not yet) ..

19* If Self, Whether Help Required under PMEGP (YES/NO)

I hereby declare that all the information given in the application are true and complete to the best of my
Knowledge and belief. I understand that action can be taken against me by the Institute if I am declared by
them to be guilty of any type of misconduct.
* All fields are Mandatory

Date---------------------------- Signature

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