Admission Form - Chandra Prabha Pvt. ITI

Chandraprabha (Pvt.) I.T.I.
All birds ﬁnd shelter during a rain. But Eagles avoid rain by ying above the clouds.
laLFkk ds mn~ns';
Problems are common, but attitude make the difference. With this vision and attitude all
pUnzizHkk izkbosV vkbZ-Vh-vkbZ- dk mn~ns'; Nk= ,oa
the member of Chandraprabha Welfare Education Society, epitomizes the sunower and
Nk=kvksa dks vkS|ksfxd izf'k{k.k nsuk gSA ftlls os Hkfo"; esa
its attributes.
jkstxkj izkIr dj lds ;k Lo;a dk O;olk; LFkkfir dj ldsA
Admission Form
Please
afﬁx
photo
here
Personal Details
Student Name:
laLFkk dk iz;kl de 'kqYd esa xq.koRrkiw.kZ f'k{kk
lacU/kh ewyHkwr f'k{kk miyC/k djkuk gSA laLFkk dks iw.kZ fo'okl
gS fd ;fn fo|kFkhZ lHkh fu;eksa ,oa 'krksZ dk ikyu djs rks og
fuf'pr gh vPNs vadks esa mRrh.kZ gksxk o fu/kkZfjr le;kof/k esa
dkslZ iw.kZ dj ldsxkA
Father’s Name:
fu;e o 'krsaZ &
1- lHkh 'kS{kf.kd ;ksX;rk ,oa vU; çek.k i=ks dh Nk;k çfr
Mother’s Name:
(QksVks dkWih) jktif=r vf/kdkjh }kjk lR;kfir gha ekU;
gSA
E-mail ID:
2- fdlh Hkh fo|kFkhZ dks laLFkk esa ços'k nsus ;k u nsus dk vf/kdkj
laLFkk ds ikl lqjf{kr gSA
Please specify your email ID (required).
Mobile No.:
Land line No.
Please specify (required).
Specify, If you have land line Number.
3- vxj dksbZ Nk=@Nk=k fu/kkZfjr le;kuqlkj Qhl tek ugha
djrk@djrh gS rks ;g eku fy;k tk;sxk fd Hkfo"; es
Gender:
Male
laLFkk es v/;;u djus esa :fp ugh gS] vr% 15 fnuksa ds ckn
Date of Birth:
Female
Date
Month
ukekadu fujLr dj fn;k tk;sxkA
Year
4- Qhl tek djus ds ckn fdlh Hkh ifjfLFkfr es Qhl okil ugha
Select with 
gksxh vkSj u gh lek;ksftr dh tk,xhA ftl fnukad dks
Address:
House No.
laLFkk NksMus dk vkosnu fd;k tk,xk] laEiw.kZ cdk;k laLFkk
Street Line 1:
es tek djus ds ckn gh vukifÙk i= fn;k tk,xkA
5- LkS/kkfUrd fo"k;ksa ds çf'k{k.k fd vof/k rFkk miyC/k LFkku
Line 2:
laLFkk es miyC/k lqfo/kkvksa ,oa lalk/kuks ij vk/kkfjr gS]
tks Nk=@Nk=k iwjs euks;ksx o esgur ls i<+kbZ
Line 3:
djsxk@djsxh] mls dkslZ iw.kZ djus es vf/kd le; Hkh yx
Pincode
ldrk gS] blds fy, og Lo;a ftEesnkj gksxkA
6- laLFkk }kjk le;& 2 ij vk;ksftr gksus okys v/;;u
Trade applied for-
dk;ZØe es mifLFkr gksuk çR;sd Nk=@Nk=k ds fy,
vfuok;Z gSA
Examination
Passed
Passing
Year
Subject
Board
Grade
7- fcuk laLFkk fd vuqefr ds fdlh Hkh çdkj fd vU; fdlh
ijh{kk es lEefyr gksus ij Nk=@Nk=kvksa dks fu"dkflr
10th
fd;k tk ldrk gSA
12th
8- fdlh Hkh fookn dh fLFkfr esa U;k;kyhu {ks= dksV}kj
Other If any
(mÙkjk[kaM) jgsxkA
Category
SC
ST
OBC
General
I, hearby, declare that information given herein is correct to the best of my knowledge and belief.
Place:
Date:
Signature (Parents)
Signature (Student)
Chandraprabha (Pvt.) I.T.I.
firk@vfHkHkkod }kjk iwfrZ gsrq
gekjs }kjk laLFkk ds fu;eks ,oa 'krksZ dk ikyu fd;k tk,xkA geus laLFkk ds lHkh fu;e o 'krsZ le> yh gSaA ge ;g Hkh
tkurs gS fd fdlh Hkh fu;e ,oa 'krZ dk mya?ku djus ij çca/kd }kjk Nk= dks laLFkk ls fu"dkflr fd;k tk ldrk gSA ge opu nsrs
gS fd mijksä ifjfLFkfr es vxj Nk=@Nk=k dks laLFkk ls fu"dkflr fd;k tkrk gS] rks ges dksbZ vkifÙk ugha gksxh ,oa u gh dksbZ Qhl
okil ysus dk vf/kdkj gksxk] geus laLFkk }kjk nh tkus okyh lqfo/kkvksa dks ns[k o le> fy;k gS ,oa mlls larqLV gSA
fnukad ----------------------------------
Nk=@Nk=k ds gLrk{kj------------------------------
LFkku ------------------------------------
vfHkHkkod ds gLrk{kj -------------------------------
Nk=@Nk=k ---------------------------------------------------------------------------dks----------------------------------------------------------- O;olk; esa izos’k fn;k tk ldrk gSA
fnukad ----------------------------------
gLrk{kj izkpk;Z
FOR OFFICE PURPOSE ONLY
Received following documents.
(a)
(b)
©
(d)
(e)
(f)
(All Subjects in Kotdwara Jurisdiction)

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