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CENTRAL TOOL ROOM & TRAINING CENTRE

(Ministry of Micro, Small & Medium Enterprises, Govt. of India)


Bon Hooghly Industrial Area, Kolkata 700 108.
Phone: (033) 25788769/25771068 Fax: (033) 25772494
E-Mail: cttckolkata@vsnl.com Website: www.msmetoolroomkolkata.com

AN ISO 9001:2000 REGISTERED ORGANIZATION

APPLICATION FORM
FOR SUMMER/WINTER VACATION TRAINING PROGRAMME
(PLEASE FILL IN USING BLOCK LETTERS)
NAME OF THE COURSE APPLIED:...

1.

Name of the Applicant

2.

Fathers Name

Affix your
attested
Passport size
:. Photograph
:.

3.

Date of Birth

4.

Sex

5.

Nationality

6.

Category

7.

Address for correspondence :.

FROMTO.

D D

Male

GEN

Female

OBC

SC

ST

MINORITY

..
..
Pin:...
E-Mail:.
8.

Contact Phone No.


(Compulsory)

9.

Name of the College with

Full Address(Compulsory) .
.
10.

11.

State..Pin.
Educational/Technical Qualification:
College Name
Diploma/
Year of
University Registration
Degree in
Study
No./Roll No.

Accommodation can be made available at the Centre or at local area at extra cost(Please tick
whether accommodation : Required/Not Required).

I do hereby declare that the information given in this application are true and complete to the best of
my knowledge and belief.
Place :.
Date :.

Signature of Applicant

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