Undertaking

I,…………………………………………….., Son/Daughter/Wife of ………………………………………………….., undertake

that I am participating as a trainee at CSC Skill Centre……………………………………………………………………..,
authorized training center of CSC e-Governance Services India Ltd. for
.…………………………………………………Course/Job Role, under the Skill Development training of Person with
Disability (PwD) candidates, under implementation of National Action Plan under SIPDA scheme and
have not undergone any other skill training course sponsored by the Government of India during the
period of 2 years prior to the last date of receipt of application for the course.

That, my above-mentioned statement is correct and true.

Applicant Representative of Training Centre:

Name: VLE Name:
Phone No.: VLE/CSC ID:

Signature: Signature: