Application Form

FOR APPRENTICESHIP TRAINING IN HAL, BANGALORE ... Mobile: I hereby declare that the above information is true to the best of my knowledge. Place: Date:.
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APPLICATION FOR SELECTION OF ITI PASSED CANDIDATES FOR APPRENTICESHIP TRAINING IN HAL, BANGALORE Note: Candidates are advised to register as Apprentice in the portal and the number to be indicated in the application form (Web Site Name www.apprenticeship.gov.in). Sl. No.

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Details Apprentice Registration No. Name of the Candidate (in capital letters) Father’s Name (in capital letters)

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Date of Birth

5

Sex

6

Educational Qualification

6.1

Total marks scored in SSLC (Enclose copy of Certificate)

6.2

Trade in ITI

6.3

Total marks scored in ITI Examination (Enclose Copy of Certificate)

6.4

Paste your recent Passport size Photograph Marks Scored ______ out of ______

SEM I

SEM II

SEM III

SEM IV

TOTAL

TOTAL MARKS SCORED

Percentage

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Caste (in capital letters)

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Category to which you belong ( Please put a TICK (√) Mark)

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Particulars

Please enclose relevant certificate in case of ST/SC/OBC/PH/Armed Force Postal Address (in capital letters) ** PIN CODE IS ESSENTIAL

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SC Scheduled Castes

ST

OBC

PH

Scheduled Tribe

Other Backward Castes

Physically Handicapped

Certificate Enclosed ( Please put a TICK (√) Mark)

YES

Armed Force

GM General Merit

NO

_________________________________________ _________________________________________ _________________________________________ _________________________________________ PIN: Landline:

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Contact Number Mobile:

I hereby declare that the above information is true to the best of my knowledge. Place: Date:

Signature of the Candidate(please sign in the box)