GOA SHIPYARD LIMITEDVASCO DA GAMA, GOA

APPLICATION FOR APPRENTICESHIP TRAINING

1. Name in full : ___________________________________________

2. (a) Permanent Address: (b) Correspondence Address:_________________________ ______________________

_________________________ ______________________

_________________________ ______________________

_________________________ _______________________

3. Date of Birth : Present age : ___________

4. Whether General / SC / ST / OBC / PH: _______________

5 Educational Qualification:

Examination Passed Name of the Institute / College Year of passing

Class / Division

6. Experience (If any):

Name of the Organization Designation From To No. of years

7. Employment exchange no. - _____________________________

8. Landline: ____________________ Mobile: _____________________

I hereby declare that the above statements are true and complete to the best of my knowledge and belief. In the event, the information is found to be false or incorrect, my candidature/appointment may be considered terminated without any notice.

N.B: Attach attested copies of all certificates (Signature)

AFFIX RECENT PHOTO