Industrial Training Institute
APPLICATION FORM
(Post Matric/Under Matric Trade)
INDUSTRIAL TRAINING INSTITUTE (ITI), BARKHETRI
BARKHETRI, BAMUNBARI, DIST.- NALBARI (ASSAM) PIN - 781312
Run by NRDS Group of Institution under PPP Mode
Recent
Passport Size
Photographs
Trade Applied :
(Fill up the form in Block letter in English using Blue/Black ink only)
Present Address :
Vill/Town
P.O. P.S.
Dist. State
PIN Ph.
Permanent Address :
Vill/Town
P.O. P.S.
Dist. State
PIN Ph.
Nationality Religion
Email
Category SC ST OBC MOBC Others Date of Birh
Sex M F Married Unmarried
Name of (%) of
from HSLC Year of Passing Division
Board/University Marks
Onwards
time of Admission original must be shown)
Declaration by Candidate
I hereby declare that the above information provided is correct and I agree to abide by all Rules
& Regulations of the Institution and consent that I would be liable to punishment for violation of rules &
regulations.
Full Signature of the Guardian Full Signature of the Candidate
Date - Date -
OFFICE USE ONLY
Signature of form Receiver Signature of In-Charge
Industrial Training Institute
APPLICATION FORM
(Post Matric/Under Matric Trade)
INDUSTRIAL TRAINING INSTITUTE (ITI), MANGALDAI
PRAFULLANAGAR, NEAR MAHARSHRI VIDYA MANDIR, DIST.-DARRANG (ASSAM) - 784125
Run by NRDS Group of Institution under PPP Mode
Recent
Passport Size
Photographs
Trade Applied :
(Fill up the form in Block letter in English using Blue/Black ink only)
Full Name of the Applicant (As per Certificate)
Father’s Name (As per Certificate)
Mother’s Name (As per Certificate)
Present Address :
Vill/Town
P.O. P.S.
Dist. State
PIN Ph.
Permanent Address :
Vill/Town
P.O. P.S.
Dist. State
PIN Ph.
Nationality Religion
Email
Category SC ST OBC MOBC Others Date of Birh
Sex M F Married Unmarried
Academic Qualification Details
Qualification Name of
(%) of
from HSLC Year of Passing Board/ Division
Marks
Onwards University
Attested Copies of Admit, Marks Sheet, Pass Certificate, Cast Certificate should be attached (at the
time of Admission original must be shown)
Declaration by Candidate
I hereby declare that the above information provided is correct and I agree to abide by all Rules
& Regulations of the Institution and consent that I would be liable to punishment for violation of rules &
regulations.
Full Signature of the Guardian Full Signature of the Candidate
Date - Date -
OFFICE USE ONLY
Signature of form Receiver Signature of In-Charge
Industrial Training Institute
APPLICATION FORM
(Post Matric/Under Matric Trade)
INDUSTRIAL TRAINING INSTITUTE (ITI), GOLOKGANJ
NEAR FIRE & EMERGENCY OFFICE, GOLOKGANJ, DIST.-DHUBRI (ASSAM) - 783334
Run by NRDS Group of Institution under PPP Mode
Recent
Passport Size
Photographs
Trade Applied :
(Fill up the form in Block letter in English using Blue/Black ink only)
Full Name of the Applicant (As per Certificate)
Father’s Name (As per Certificate)
Mother’s Name (As per Certificate)
Present Address :
Vill/Town
P.O. P.S.
Dist. State
PIN Ph.
Permanent Address :
Vill/Town
P.O. P.S.
Dist. State
PIN Ph.
Nationality Religion
Email
Category SC ST OBC MOBC Others Date of Birh
Sex M F Married Unmarried
Academic Qualification Details
Qualification Name of
(%) of
from HSLC Year of Passing Board/ Division
Marks
Onwards University
Attested Copies of Admit, Marks Sheet, Pass Certificate, Cast Certificate should be attached (at the
time of Admission original must be shown)
Declaration by Candidate
I hereby declare that the above information provided is correct and I agree to abide by all Rules
& Regulations of the Institution and consent that I would be liable to punishment for violation of rules &
regulations.
Full Signature of the Guardian Full Signature of the Candidate
Date - Date -
OFFICE USE ONLY
Signature of form Receiver Signature of In-Charge
Industrial Training Institute
APPLICATION FORM
(Post Matric/Under Matric Trade)
INDUSTRIAL TRAINING INSTITUTE (ITI), DALGAON
KACHARIPARA, NEAR PANDIT DEENDAYAL UPADHAYA ADARSHA MAHAVIDYALAYA,
DALGAON, DIST.-DARRANG (ASSAM) - 784116
Run by NRDS Group of Institution under PPP Mode
Recent
Passport Size
Photographs
Trade Applied :
(Fill up the form in Block letter in English using Blue/Black ink only)
Full Name of the Applicant (As per Certificate)
Father’s Name (As per Certificate)
Mother’s Name (As per Certificate)
Present Address :
Vill/Town
P.O. P.S.
Dist. State
PIN Ph.
Permanent Address :
Vill/Town
P.O. P.S.
Dist. State
PIN Ph.
Nationality Religion
Email
Category SC ST OBC MOBC Others Date of Birth
Sex M F Married Unmarried
Academic Qualification Details
Qualification
Name of (%) of
from HSLC Year of Passing Division
Board/University Marks
Onwards
Attested Copies of Admit, Marks Sheet, Pass Certificate, Caste Certificate should be attached (at the
time of Admission original must be shown)
Declaration by Candidate
I hereby declare that the above information provided is correct and I agree to abide by all Rules
& Regulations of the Institution and consent that I would be liable to punishment for violation of rules &
regulations.
Full Signature of the Guardian Full Signature of the Candidate
Date - Date -
OFFICE USE ONLY
Signature of form Receiver Signature of In-Charge
