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Application Form ADAM 2023-24
Application Form ADAM 2023-24
Phone: 011-2682662
ADVANCE DIPLOMA IN AUTOMOTIVE MECHATRONICS (ADAM)
Application Form 2023
1. PERSONAL DETAILS:
a) Name of Candidate
(in Block Letter) Affix a Recent
b) Father’s / Guardian’s
Photograph
Name & Occupation
c) Date of Birth d) Gender
e) Nationality
f) Permanent Address
PIN:
Important Instructions:
g) Address for (i) Candidates are advised
Correspondence to read information
bulletin before filling up
the application form.
PIN:
(ii) No column should be
h) Mobile No. i) Phone (R) left blank. If any column
is not applicable, write
j) e-mail N.A.
Diploma
XII
X
3. DETAILS OF WORK EXPERIENCE:
Name and address of Employer / Organization Post Held Duration
4. FEE DETAILS:
a) Name of Bank
b) Reference No. / Transaction ID c) Date
Note: Proof of Fee Paid to be scanned and sent along with this application form.
Declaration:
1. I hereby certify that the information provided by me in application form is correct to the best of
my knowledge and I have not concealed any information in any manner.
2. I certify that I am not involved in any illegal activity and no criminal case is pending against me in
any court of law.
3. If ineligibility of the candidate is detected at any stage, before or after the
examination/declaration of results, or during any stage of the course, his/her
candidature/admission will be cancelled without any notice. Disciplinary action will be taken
against him/her and entire fee will also be forfeited.
I hereby declare that I have read and fully understood all the conditions above and freely agree
to abide by them.
Date:
Date of receipt
Remarks, if any