Admission Form

PRAVAH SKILL DEVELOPMENT CENTRE

Select centre:

NAME OF STUDENT:

FATHER’S/HUSBAND NAME:

FILE:

CATEGORY (TICK √ )

General

OBC

GENDER

DATE OF BIRTH (DD/MM/YYYY)

PERMANENT ADDRESS:

MOBILE NUMBER

EDUCATIONAL QUALIFICATIONS:

QUALIFICATION	UNIVERSITY/BOARD	SUBJECTS	YEAR OF PASSING	GRADE / PERCENTAGE

Declaration:

I hereby declare that all the statements made by me in the admission form and information documents are true and complete to the best of my knowledge and belief and nothing has been concealed or suppressed.

Date:

Signature of the Candidate Place