Sr. No.______
Last date for submission of application :__________
Reginstration Fee: Rs.10/-
(For
Office Use Only) |
GOVERNMENT OF INDIA
MINISTRY OF LABOUR & EMPLOYMENT
ADVANCED TRAINING INSTITUTE
SION, MUMBAI- 400 022.
APPLICATION FORM FOR ADMISSION IN "OPERATION AND
MAINTENANCE OF
CHEMICAL PLANT"(OMCP-SUPERVISOR) COURSE
| Latest Photograph |
1. Name in Full (BLOCK letters) : _____________________________
2. Date of Birth : _____________________________
3. Whether belongs to SC/ST : _____________________________
4. Mailing Address (BLOCK letters) : _____________________________
_______________________________________
_______________________________________
5. Academic & Technical qualification : _______________________________________
| Exam. Passed | University / Board | Year | % of Marks | Main Subject |
|
|
6. Practical Experience :
| Firm / Department | Period |
Designation | Nature of Work |
|
| From | To | |||
|
|
||||
7. Whether Private of Sponsored
: ____________________________________
(IF sponsored indicate address of the Employer)
Date : ___________ Signature of the applicant
NOTE : 1 Attested copics of the Certificates, Degree, Diploma and Experience should be attached with the application, failing which the application is liable to be rejected.
2. DGE & T / Director of the Institute reserves the right to discontinue or alter
the course
without assigning any reason thereof.
______________________________________________________________________________________
(For Office Use Only)
ACKNOWLEDGEMENT
ADVANCED TRAINING INSTITUTE , SION, MUMBAI-400 022.
Received Rs.10/- towards Registration charges for Application Form No. ________ and
Registration No.__________ Dated __________ for admission in OMCP (Supervisor) Coruse.
Signature of the Receiving Staff.