INDO DANISH TOOL ROOM

(Ministry of MSME - Govt. of India)
(An ISO 9001:2008 & ISO 14001:2004 Certified Company)
M-4 (Part) Phase VI, Tata Kandra Road, P.O. Gamharia,Jamshedpur - 832108

Application Form for Short Term Courses

For Office Use Only

Reg. No. __________

(F/IDTR/TRG/STC AF)

Fill up and Submit this form online to pre-register yourself for a course. Also, take a print of the filled up form, and send to us along with all necessary documents by registered post/ courier.

(* Mandatory fields)

Course Applied For : *

Course Commencing date :

Timing :

Between 06:00 am to 10.00 pm (Monday To Saturday)

Name of the Applicant : *

(in Capital Letters)

Father's Name :

(in Capital Letters)

Father's Occupation :

Affix a recent
Passport Size
Photograph

Date of Birth :

(DD/MM/YYYY)

Category :

SC ST OBC GEN

Sex (M/F):

M F

Phone/ Mobile No. :

Email ID : *

Whether Sponsored (Yes/No) :

YES NO

Name of the Sponsoring Authority :
(if sponsored)

Whether require Hostel :

YES NO

How did you come to know about this course?

POSTAL ADDRESS (In Capitals) :

CORRESPONDENCE ADDRESS	PERMANENT ADDRESS

PIN :	PIN :

Educational Qualification/ Other Professional Qualification/Training Courses, etc.

Sr. No.	Exam Passed	Year of Passing	Duration of the Degree/ Diploma	Board/University	%age of Marks	Branch/Specialization

Experience(if any) :

Enclosed Cash (Money receipt no)/Draft No. : dated: for Rs.
On (Bank) Drawn in favour of Indo-Danish Tool Room, payable at Jamshedpur.

Declaration: I do hereby declare that the above information are true & I shall abide by the rules & regulations of the Institute.

Date.:
Place: Signature of Candidate
Note: 1) Please send attested copies of final/pre-final year Mark sheet.