Wave Courses Application Form

  • Published on
    23-Feb-2017

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  • Center Code: __________________________

    Center Name: _____________________________

    APPLICATION FORM for WAVE Courses

    Under Skill Development Program for Youth of Rajasthan (2012-13)

    Name of Candidate: .

    Fathers Name:

    Mothers Name: .

    Gender: Male Female DOB (DD/MM/YYYY): .

    Marital Status: Single Married Divorced Widow

    Mobile Number: Email ID: .

    Permanent Address:

    House No./Street/Area: .... City/Town/Village:

    State: Rajasthan District: Tehsil: Pin Code: ..

    Category: (Tick on your category and sub-category)

    General

    SC: TSP: District: Tehsil: . Non-TSP (MADA or Bikhri)

    ST: TSP: District: Tehsil: . Non-TSP (MADA or Bikhri)

    Saharia

    OBC: Creamy Layer Non-Creamy Layer

    SBC: Creamy Layer Non-Creamy Layer

    Caste: Religion: Hindu Muslim Sikh Christian Jain Parsi Others

    Qualification Details:

    Qualification Board/University Percentage Passing Month & Year 12th Standard (Mandatory) Diploma (Optional) Degree (Optional)

    Required Documents:

    1) 12th Standard Marksheet

    2) 10th Passing Certificate (Age-proof)

    3) Caste Certificate (If applicable)

    Declaration:

    1) I hereby declare that all the information furnished by me in this application form are

    true, complete and correct to the best of my knowledge and belief.

    2) I have not applied at any other IT Gyan Kendra for training under this scheme.

    Place:

    Date: ..

    Signature

    Photograph

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