Application_form_hindi.pdf

CENTRAL HINDI TRAINING INSTITUTE (Correspondence/Regular Course) APPLICATION FORM PROFORMA FOR ADMISSION TO PRABODH, PRAVEEN AND PRAGYA COURSES 1

Name of the Course

PRAGYA

2

Name of the Applicant (In Block Letters)

S. MANIKANDAN

3

CPF No.

43850

4

Father’s/Husband’s Name

P. SUBRAMANIAN

5

Designation of the Applicant

SUPERVISOR FC&D, GRADE - I

Complete Postal Address of Office abbreviations)

MATERIALS MANAGEMENT COMPLEX, DR. RAJENDRA PRASAD ROAD, BLOCK-27, NEYVELI T.S. CUDDALORE DISTRICT, TAMILNADU, PINCODE 607807.

7

E-Mail ID of candidate

[email protected]

8

Nationality

INDIAN

9

Date of Birth

05-06-1979

10

Mother Tongue

TAMIL

11

Academic Qualifications

MBA

Standard/Class upto which Hindi has

-NIL-

6

including Dist./State & Pin Code (Not in

12

been studied

address (In Block Letters)

T. DEVARAJ, DEPUTY GENERAL MANAGER/TS MATERIALS MANAGEMENT COMPLEX, DR. RAJENDRA PRASAD ROAD, BLOCK-27, NEYVELI TOWNSHIP, CUDDALORE DISTRICT, TAMILNADU, PINCODE 607807

14

Telephone No.

04142-268268

15

E-Mail ID

[email protected]

16

Fax

04142-269197

17

Mobile No.

9600626188

Name and Designation of the 13

Controlling Officer with full Office

(Signature of the Applicant) CERTIFICATE OF THE CONTROLLING AUTHORITY (Please ensure fulfillment of eligibility conditions before signing the certificate) Certified

that

Sh./Smt./Kum.

……………………………………………………………………………..

working

as

………………………………………… in …………………………………………………. has been found eligible for training and is permitted to be enrolled for ………………… Course through Correspondence to be conducted by the Central Hindi Training Institute in the Year ………………………………

Signature Name and Designation of the Competent/Controlling Officer With the Office Seal Fax No.…………….…………… Telephone No………………………… and Mobile No.…………………………….. Place : ………………………………. Date : ……… /……../ …………………