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GOVERNMENT OF INDIA |
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COMMON APPLICATION FORM
Name of the Training/Program:_____________________________
| 1. | Name of the Candidate (In Full & in Block Letters) |
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| 2. | Fathers/Spouses Name | |||
| 3. | Address for Correspondence | |||
| Pin Code | ||||
| Tel. | ||||
| 4. | Educational Qualification | |||
| 5. | Date of Birth | Date/Month/Year | ||
| 6. | Category | Gen | PH | |
| SC | Women | |||
| ST | ||||
| 7. | Employed | Yes | No | |
| ( If Yes, Brief of employment with Address) | ||||
| 8. | Details of the Course Fees Deposited | Amount Rs. | Cash/Demand Draft | |
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Details of DD |
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| I hereby declare that the statement made above is true to the best of my knowledge & belief. | |
| Date | (Signature) |
| Place | |