POWER DISTRIBUTION TRAINING CENTRE, BHOPAL (A Training institute of MPMKVVCL) Nishtha Parisar, Bijlinagar,Govindpura, Bhopal-462023 Phone No. 0755-2602033 To 2602036 Fax No.0755-2589821 ISO 9001-2008 APPLICATION FORM VOCATIONAL TRAINING PROGRAMME (Session 2015-2016) VOCATIONAL COURSE NAME: Electrical TRAINING PERIOD: IT/ CSE HR Finance No. of Weeks 1. Full Name of the Candidate:……………………………………………… (In Capital letters) 2. Father’s Name: …………………………………………………… Candidate Recent Photo. 3. Date of Birth : 4. Sex: Male 5. Category: SC 6. Amount Deposited: Female ST DD/Cash No. OBC GEN Date Amt (Demand draft should be in favor of “POWER DISTRIBUTION TRAINING CENTRE, SOCIETY, Payable at Bhopal “) Note: Cash payment are accepted at training centre only 7. Name Of College: …………………………………………………………………………….. 8. College Address & City: ……………………………………………………………………………… 9. Current Semester & Year of Candidate : …..…..…………………………………………………… 10. Stream/ Branch: ……………………………………………………………………………………….. 11. Address for Communication: …………………………………………………………………… Encl: College letter. …………………………………………………………………… Email Id:……………………… … Mobile No: ……………………… DECLARATION I …………………………………… S/o ……………………………….. hereby declare that all the information given by me are true/correct to best of my knowledge and if found false the benefit out of training shall be forfeited. I………………………….. also declare that I will not claim any right for appointment in the company for any vacancy available in the future. Date : Signature of the Candidate: Note: 1. Identification shall be verified at the time of Registration through your I-card. 2. One photograph alongwith letter from your institute is to be submitted prior to your registration.