GOVERNMENT OF PONDICHERRY DISTRICT INDUSTRIES CENTRE ***** APPLICATION FORM FOR HANDICRAFTS MASTER TRAINER 1. Name &Address : 2. Age & date of birth : 3. Educational qualification : 4. Name of the Crafts learnt : 5. Whether belongs to SC/ST : Yes / No 6. Previous experiences in the field : 7. Whether he/she is National/State : Yes / No Awardee? If so furnish details 8. Whether he/she has been trained by this Centre ? if so furnish details : 9. Whether he/she has give Training Centre previous years, if so give details : 10. Name & address of the units : 11. Whether the unit has been permanently registered with Industries Department? if so attach a copy : 12. Any other details : Place: Date : SIGNATURE