Application 1basant

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PART-A

Appication No. 1000005747 Training Start Date 2024-09-09 Training End Date 2024-10-05

Chargeable Category NON BSL Training Type NON PROJECT BASED Category OBC

Name of Student ABHISHEK KUMAR MAHATO Gender M

Name of Father SARVESHWAR MAHTO Name of Mother ANJU DEVI

Name of Institute GGSESTC CHAS BOKARO Name of University JHARKHAND UNIVERSITY OF TECH

E-mail of Institute [email protected] Training Weeks 4

Branch MECHANICAL Semester 7 Year 4

E-mail of Student [email protected] Mobile No. 9117223998

Address VILL-PARSABERA,PO-CHIKSIA,PS-CHAS,BOKARO

State JHARKHAND Pin 827013

PART-B(to be filled by On-Roll/Ex BSL Employee)

I hereby declare that I will take full responsibility for the conduct of the student during the training period.

Signature...........

Name of BSL On-Roll/Ex Employee:

Designation:

Staff Number/SAIL Pers. No.:

Forwarded (Signature and seal of E4 and above executive of BSL)

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