PERFORMA OF APPLICATION FORM FOR SHORT TERM COURSE

1. Name of the short term course

अल्पावधि पाठ्यक्रम/शार्ट र्मट का नाम

……………………………………………………

2. Name (in block letters) Miss/Mrs

नाम कुमारी/श्रीमती

…………………………………………………….

3. Name : Father's

पपता का नाम

…………………………………………………….

Name : Husband's

पतत का नाम

…………………………………………………….

4. Date of Birth

जन्म ततधि

…………………………………………………….

5. Residential Address

घर का पता …………………………………………………….

6. Telephone No.

दरूभाष

…………………………………………………….

Mobile No.

मोबाइऱ

…………………………………………………….

7. Qualification (Academic)with Certificate शैक्षिक योग्यता

…………………………………………………….

Signature of Applicant

प्रािी के हस्तािर

Application form for short term course can also be downloaded from the Website

www.dget. nic.in