Aaganwadi Worker Training Program Run by: AA ANNAPURNA YUTH SOCIETY Regd. by Govt. of NCT of Delhi (INDIA) A Social Awareness Self Training Program AN ISO 9001: 2008 certified NGO Admission Form Aaganwadi Supervisor Aaganwadi Worker Aaganwadi Helper 1. Name of candidate………………………………………………………………………………. 2. Father Name…………………………………..3. Husband Name………………………………. PHOTO 4. DOB………………………… E-mail…………………………………………………………… 5. Postal Add. ……….………………………………………………………….. Sex Male/Female 6. Present Add……………….……………………………………………………………………… 7. Category…………………………………………….Phone / Mobile No……………………….. 8. Education Qualifications Class 9. 10. 11. 12. 13. Board/ Univ. Passed Year Total Marks Obtain Marks Percentage 8th 10th 12th B.A. Other Experiences ……………………………. CHEQUES /DD/RTGS/NEFT NO.……….Bank Name.………Date………….Amount………. State Black District Pin Code Attached Document List A) RTGS/ NFET Receipt. B) 2 Photos. C) Self-attested Document. D) One Photo copy of Rasan Card/ Voter ID/ Aadhar Card/ Bank Pass Book/ Passport/ Permanent Add. Prof. E) Photo copy of SC/ST/Widow and Handicap Certificate. F) Admit Form by speed post, registry courier and by self. I…………………………….Father/ Husband………………..Declare a) My self-declare Above Document are true and correct. b) I read All Terms and Conditions with carefully. I determined I would follow all the rules. c) If any information fills incorrect by the candidate, society cancelled the admission form. Candidate Signature …………………………………………………………………………………………………… For official Use Only Registration No……………………..Candidate Name…………………………………………. Photo Father / Husband Name………………State ….………….District…………Pin Code………… Block…………. ………. CHEQUES /DD/RTGS/NEFT NO………………………………..… Amount……………...................................... Date……………………………………………... Officer Signature