|
To
Kshitij
|
|
|
|
Attach
Your
Two
Latest Passport Size
Photos.
Please
Do Not
Paste
it.
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| Applicant's
Name:.................................................................................................................................................... |
| Father's/Husband's
Name:.......................................................................................................................................... |
| Date
of Birth &
Place:..........................................................
General
Qualification:........................................................ |
| Technical
Qualification:......................................................
Occupation:..................................................................... |
| Permanent
Address :
................................................................................................................................................. |
| ............................................................................................................................................................................. |
| STD
: ....................... Ph.
No :.......................................
Email :
............................................................................... |
| Correspondence
Address :
.......................................................................................................................................... |
| .............................................................................................................................................................................. |
| STD
: ....................... Ph.
No :.......................................
Email :
................................................................................ |
|
| Any
other information :................................................................................................................................................ |
| ............................................................................................................................................................................... |
| ................................................................................................................................................................................ |
|
I
hereby declare, the above mentioned facts are true to the best of my
knowledge. I agree to abide
by
the rules and regulations of the Kshitij.
|
|
| I
herewith enclose Rs. 1000/- by cash or
D.D.
(in favour of “Kshitij”,
payable at New Delhi or Gurgaon)
|
| Demand
Draft No. ................................
Dated
................................ |
|
| Date:........................ |
|
Signature of
Applicant |
|
(Printout/ Copy/ Photocopy can be used.) |
-774.jpg)