30% X (1) 05% XII (2) 05% Degree (3) 50% NTC (4) 60%NAC (5) 60%diploma (6) Total 100% ( )
30% X (1) 05% XII (2) 05% Degree (3) 50% NTC (4) 60%NAC (5) 60%diploma (6) Total 100% ( )
30% X (1) 05% XII (2) 05% Degree (3) 50% NTC (4) 60%NAC (5) 60%diploma (6) Total 100% ( )
GUINDY, CHENNAI-600032
PHONE: 044-22500252, 22501211 FAX: 044-22501460 E-MAIL [email protected]
2010-11
* 1+2+3+ (4 or 5 or 6)
Registration No
APPLICATION FOR ADMISSION IN CRAFT INSTRUCTOR COURSE (To be filled by the candidate) 1) Name in full (IN BLOCK LETTERS):
PHOTO 2) Date of Birth: 3) Nationality: 4) Fathers/Husbands Name: 5) Residential Address: Door No.: District : PIN Code: Name of the Street: City Contact Cell Phone No. Village /Area State E-mail
6) SEX
7) Whether belongs to SC/ST/PH/EX/Category: YES / NO, (Certificate to be enclosed) 8) Details Previous Modules Completed: Name of the Module completed Engg.Technology Trade Technology -1 Trade Technology -2 Month and Year Result Pass / Fail
Admission No
9) Module for which admission is required: (Refer prospectus for details) 10) Date of commencement of course (Refer prospectus for details)
ATI GOVERNMENT OF INDIA MINISTRY OF LABOUR & EMPLOYMENT Directorate General of Employment and Training ADVANCED TRAINING INSTITUTE, GUINDY, CHENNAI-600032
PHONE: 044-22500252, 22501211 FAX: 044-22501460 E-MAIL [email protected]
2010-11
Year Class
% of Marks
Main Subject
(Attested Photostat copies of mark sheets, to be attached) b) Technical: Sl.No Certificate/ Trade/ Branch Institute attended Diploma 1 2 3 NTC NAC Diploma
Year of passing
% Remarks of Marks
(Attested Photostat copies of mark sheets, to be attached) 12) Payment Details of Registration Fee. IPO / DD No. Date Amount Name of the Bank/Post Office 13) Any other Particulars : I certify that the information given in item 1 to 13 is correct to the best of my knowledge and belief. In the event of my selection for admission to the institute, I undertake to abide by the rules and regulations and discipline of the institute
Date: Station:
II Quarter 24 December2010
th