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JBTech INDIA

Greater Noida
(VLSI Design solutions and Project Training)

Reg. No.: ---------------( for office use only)

APPLICATION FORM
:_________________________________________

1. Name (In Block Letters)

Affix recent

2. Fathers/Guardian Name

:___________________________________________________
Passport size

3. Correspondence Address:

____________________________________________________

Photograph

____________________________________________________
___________________Pin Code__________________________
____________________________________________________

4. Permanent Address:

____________________________________________________
___________________Pin Code__________________________
1. _____________@___________________________________

5. E-mail Id:

6. Phone (With STD code) / Mobile: ________________/________________ /________________


7. Educational Details :
Degree

Branch/Subjects

University/College

Passed in

Division

VLSI-FIT

&

VLSI-ILP-2

&

Percentage

B.Tech.
Other

1. Training
VLSI-DST
& CC:_____
2. Industry level Project
VLSI- ILP-1
&
_____________

8. Want to Join :

9. Duration

Declaration by candidate
I, _____________________S/O, D/O Sh._______________________hereby declare
that all particulars Stated in the application are true to best of my knowledge and belief. In
case of discrepancies, at any Time i.e. from start to the end of the program will subject to
the cancellation of my candidature
Date :

Signature of the Candidate

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