S.R.D.F/Y.S.P.

Rojgar Kaushal Prashikshan Kendra

Ward No. 4
V.P.O Bhanjal Lower
Tehsil Ghnari Distt UNA
Himachal Pradesh
Pin Code: - 177213

APPLICATION FOR REGISTRATION AS TRAINEE

TO BE COMPLETED IN BLOCK LETTERS

PARTICULARS OF TRAINEE:

1. Name: ……………………………………………………………………………………............................
2. Father/Husband Name …………………………………………………………………………………….
3. Date of Birth ……../………/……………. 4. Enrolment Number :

4. Aadhaar. Number ……………………………………………………………………….

5. Marital Status Married Single Male Female

6. Residential Address:

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……………………………………………………………………………………………………………………....

7. Contact Number ……………………… …………9. Alternate Number: ……………………………

8. Experience, if any ……………………………………………………………………………………………
9. Father/Husband Occupation: …………………………………………………………………………
10. Blood Group…………………………………………………………………………………………………

…………………………………… …………………………………….
SIGNATURE DATE

FOR OFFICE USE ONLY

Checked by…………………………………………………………………………… Date………………………………………………………

Remarks: ……………………………………………………………………………………………………………………………………….
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