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  • ApplicationFormComplete (15-08-2021 21 - 06 - 03)

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    Ankush Ankush
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    This document contains an application form for admission to a Diploma in Engineering program. It includes personal details of the candidate such as name, gender, date of birth, family income, education qualifications, and contact information. It also lists the name and address of the candidate's previous institute. Payment details such as the transaction number, amount, and date are provided. At the bottom, the candidate declares that the information provided is true and correct and that they have read and will abide by the terms and conditions for admission.

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    1629041763__ApplicationFormComplete(15-08-2021 21_06_03)

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    This document contains an application form for admission to a Diploma in Engineering program. It includes personal details of the candidate such as name, gender, date of birth, family income, education qualifications, and contact information. It also lists the name and address of the candidate's previous institute. Payment details such as the transaction number, amount, and date are provided. At the bottom, the candidate declares that the information provided is true and correct and that they have read and will abide by the terms and conditions for admission.

    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    4 views1 page

    ApplicationFormComplete (15-08-2021 21 - 06 - 03)

    Uploaded by

    Ankush Ankush
    This document contains an application form for admission to a Diploma in Engineering program. It includes personal details of the candidate such as name, gender, date of birth, family income, education qualifications, and contact information. It also lists the name and address of the candidate's previous institute. Payment details such as the transaction number, amount, and date are provided. At the bottom, the candidate declares that the information provided is true and correct and that they have read and will abide by the terms and conditions for admission.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 1

    THE PUNJAB STATE BOARD OF TECHNICAL EDUCATION

    & INDUSTRIAL TRAINING, CHANDIGARH

    Application Form for Admission

    (Diploma in Engineering)

    APPLICATION NUMBER

    1001806

    Candidate Details

    Name:- ANKIT Gender:- MALE

    Father Name :- RAJKUMAR GUPTA Contact No:- 9888696505

    Mother Name:- ANITA DEVI E-mail ID:- SK7438105@GMAIL.COM

    Date of Birth:- 22-Feb-2003 Nationality:- INDIAN

    Punjab Domicile :- NO Religion:- HINDU

    Area :- URBAN State:- Chandigarh

    Category :- BC - Backward Class District:- Chandigarh

    Sikh Minority :- -- Annual Family Income:- Less than 8 Lacs

    Education Qualification:- 10th Standard/SSC Examination Belong to Fee Waiver:- YES

    Pass Status :- Passed Board Name:- Central Board of Secondary Education

    Result Mode:- Percentage Year of Passing:- 2019

    Marks Obtained:- 210 Total Marks:- 500

    Roll No:- 2358162 Percentage:- 42.00000

    Institute Name & Address

    Name: Govt model high school

    Address: Govt model high school sector-26 Chandigarh

    State: Chandigarh District: Chandigarh PIN Code: --

    Payment Detais

    Transaction No:- 100180615205607

    Amount(Rs.):- 550.00 /-

    Amount(In Words):- (Rs.) Five Hundred And Fifty And Zero Paise Only

    Transaction Date:- 15-08-2021 21:05:45

    DECLARATION: I hereby declare that:


    1. All statements made in this application form regarding age limit & educational qualifications etc. are true, correct and complete to the best of my
    knowledge, belief, record and nothing has been concealed therein. In the event of any information being found/detected false, incorrect, incomplete and
    ineligible before or after the selection then my candidature may be cancelled and any legal action as per law can be intiated/taken against me.
    2. I have read the terms and conditions prescribed in advertisement as well as uploaded on the website carefully and accordingly, I hereby undertake to
    abide by them. I, also, fulfill all the conditions of eligibilty as per relevant rules and instructions prescribed by PSBTE,Punjab from time to time.
    3. I have never been convicted by any competent court of law.

    Signature of Student

    Page 1 of 1 (15-08-2021 21:06:03)

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