Application for Short Term course 1) Name of the course:-................... Candidates Photograph 2) Candidates full name In block letters: Miss/Mrs........................... 3) Nationality:-.......... 4) Complete postal address for correspondence:- C/o:- ............................... ................................. House No:- Street No / Land mark ______________________ Locality / Area:- Post Office:- ______________ Village / Taluka:- Dist:- __________________ State:- Pin Code:- ___________ 5) Telephone number if available:- STD _______. Ph.No._______________ 6) Date of birth :- . Age:-_______ years. 7) Qualifying examination passed:- ______________________ 8)Year of passing:- _______________. 9) Hostel accommodation: - Required:/ Not required. Candidates Signature with date.
