Candidate Basic Details: |
Candidate Personal Details: |
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First Name * | ID Card Type * | |||
Last Name | ID Card Number * | |||
Gender * | Qualification * | |||
Date of Birth * | Employment Exchange Number * | |||
Mother Name * | Religion * | |||
Father Name * | Category * | |||
Current Address Details: |
Permanent Address Details: |
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C/O or S/O or D/O * | (Is Permanent Address Same As Current Address? *) | |||
Village/ Town * | Village/ Town * | |||
Street/ Landmark * | Street/ Landmark * | |||
Post Office * | Post Office * | |||
Pin Code * | Pin Code * | |||
District Name * | District Name * | |||
Other Details: |
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Is BPL Card Holder? * | YesNo | Is Antodaya Card Holder? * | YesNo | Is MGNREGA Card Holder? * | YesNo | ||
Is Minority? * | YesNo | Is BoCW (Building and Costruction Worker)? * | YesNo | Is Tea Tribe Minority? * | YesNo | ||
Are you Person with Disability? * | YesNo | Assembly Constituency * | Is City / Village? * | CityVillage | |||
Course Preference: |
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Course Category * | Training Center (1st Preference) * | |||
Course Name * | Training Center (2nd Preference) Optional |
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Educational Qualification: |
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Examination | Board/ University | Marks Obtained | Division/ Grade | Year of Passing | ||||
Computer Diploma/ Certificate: | ||||||||
Documents Upload |
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1 | Recent Pass Port Size Photograph | Pending Passport Photo Upload |
2 | Signature of Applicant | Pending Signature Upload |
3 | Age Proof (Admit Card HSLC/Pass Certificate) | Pending Age Proof Upload |
4 | Highest Qualifying Certificate | Pending Certificate Upload |
5 | HS (10+2) Marksheet | Pending Marksheet Upload |
Skill Development and Training on IT |
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Application Form | ||||||||
1 | Applicant Name | |||||||
2 | Gender | |||||||
3 | Date of Birth | |||||||
4 | Mother Name | |||||||
5 | Father Name | |||||||
6 | ID Card Type | |||||||
7 | ID Card Number | |||||||
8 | Qualification | |||||||
9 | Employment Exchange Number | |||||||
10 | C/O or S/O or D/O | |||||||
11 | Present Address | |||||||
12 | Permanent Address | |||||||
13 | Course Category and Name | |||||||
14 | Training Center (1st Preference) | |||||||
15 | Training Center (2nd Preference) |
16 | Educational Qualification | |||||||
Examination | Board/ University | Stream | Division/ Grade | Year of Passing | ||||
17 | Computer Diploma/ Certificate |
18 | Recent Pass Port Size Photograph | Signature of Applicant | Age Proof | Highest Qualifying Certificate | HS (10+2) Marksheet | |||||
I HEREBY DECLARE THAT THE INFORMATION SUBMITTED BY ME IS CORRECT AND TRUE TO THE BEST OF MY KNOWLEDGE. I SHALL BE LIABLE FOR ANY DISCIPLINARY/PUNITIVE ACTION IN CASE ANY OF THE DETAILS ARE FOUND TO BE INCORRECT. |
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