NATIONAL BOOK TRUST, INDIA

Nehru Bhawan, 5 Institutional Area Phase II Vasant Kunj, New Delhi-110070 Phone: 011-26707700

Application form for Admission 2013-14 Training Course in Book Publishing (Delhi)

Regn. No. Date: DD Name: Address: Please affix your recent photograph PIN Phone: email id: Date of Birth: DD Parent/Guardian Name: Education: (Please start from last qualification) Institution Degree/Diploma Div./Rank Subject Year MM YY Sex: Male Female MM YY (To be filled at the time of registration)

Work Experience: Organisation From To Designation Nature of Work

(Please enclose photocopies of the certificates in support of educational qualification and work experience) Declaration: I have read the course brochure and the terms and conditions. I agree to abide by them. Questionnaire attached Signature of the Applicant