Industrial Fire and Safety

APPLICATION / REGISTRATION FORM

1. Name of the training course applied for

2. Name of the Candidates (capital letter)

3. Father’s/ Husbands name

4. Present/Address for communication

5. Permanent Address (with pin code No.)

6(a). Contact Tel. No./ Mobile Number

6(b). Contact Tel. No./ Mobile Number

8. Email Id

9. Date of Birth:

10. Whether SC/ST/OBC/MINORITY/PH

11. Educational Qualification

12. Technical Qualification

13. Annual Income of the Family

14. Aadhar Number

15. Any other information

Note:Name of the Secretary/ President/ Manager & Address of Professional Training Associates

I hear by declares that, the statements made as above are correct & incase of any discrepancy found there in, I shall responsible for the consequences

About Us

APPLICATION / REGISTRATION FORM

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