Name:*

Father Name:*

Mother Name:*

Date Of Birth:*

Aadhar Number:*

Category:* -- Select One -- SC ST OBC General

Gender:* -- Select One -- Male Female

Phone:*

Second Phone:*

Year of Passing SSC (10th):* -- Select Year -- 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023

Percentage in Class SSC (10th):*

Trade/Stream:* -- Select Year -- Fitter Turner Motor Mechanic Welder Painter (General) Electrician Tool & Die Maker Plastic Process Operator Machinist Tractor Mechanic COE (Automobile) Diesel Mechanic

ITI Board (Certification):* -- Select One -- NCVT SCVT OTHER

Year of Passing ITI:* -- Select Year -- 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023

Percentage in ITI:*

ITI College Name:*

E-mail:*

Blood Group:* -- Select One -- A+ A- B+ B- AB+ AB- O+ O-

Permanent Address:*

State:* -- Select Your State -- Bihar Gujarat Chhattisgarh Himachal Pradesh Jharkhand Madhya Pradesh Maharashtra Odisha Rajasthan Uttar Pradesh Uttarakhand District:* -- Select Your District --