Affiliation Application

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Affiliation Application

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APPLICATION FORM FOR AFFILATION

State*

District*

City*

Institute Information :

Name of the Institute *

Year of Establishment *

Status of The Institution*

P.O.*

P.S.*

Pin*

Postal Address of the Institute*

Institute Contact No.

Phone1 *

Phone2

Email ID *

Information About Centre Head :

Name of the Head *

Position Hold Centre *

P.O *

Address of the Centre Head*

Pin*

P.S *

Mobile*

Email of the Centre Head*

Date of Birth *

Nationality *

Religion *

Gender*

Available Infrastructure Facility of the Centre :

DOCUMENTS :

Color Passport Size Photo Of The Centre Head*

Voter Card Of The Institute Head*

Pan Card Of The Institute Head*

Trade License Of The Institute*

Color Photo Of Office Room

Color Photo Of Practical Room

Color Photo Of Theory Room

DECLARATION

I hereby certify that the context stated above are correct and true to my knowledge and belief and hereby confirm that our Organization / Society / Trust is free from any legal / official disputes whatsover.I accept that any facts stated above. I found incorrect will automatically result in cancellation for nominations associate.However I will have no right whatsover to fight / challenge legally against the judgment in any court of law.