CENTRAL TOOL ROOM AND TRAINING CENTRE

(An Indo-Danish Project , A Govt. of India Society )
Plot No.-B-36 , Chandka Industrial Area
 Bhubaneswar - 751 024 (Orissa)
 
APPLICATION FORM FOR  ADMISSION INTO

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(NOTE: Please use the Print option on your browser to make a hard copy of this form, fill it up and mail it to the address given on the form along with the draft.)

1.Name :Mr./Miss             ________________________________________________________
2.Father's Name  ________________________________________________________
3.Sex (M/F)       ________________________________________________________
4.Date Of Birth    ________________________________________________________
5.Address for correspondence:  ________________________________________________________
 ________________________________________________________
 ____________________________________Pin _________________
6.Phone /Fax No. (If any)   ________________________________________________________
7.Qualification   ________________________________________________________
Degree/Diploma in ____________________________ age of Marks in final or prefinal ________
8.Payment of Registration fees details      : 
D/D No.______________________
Name of the Bank ___________________Place_______________________
9.Category :  Non Sponsored         Sponsored  
In case of sponsored candidate:      Signature with seal
Name & Address of Sponsoring Authority

DECLARATION

I do here by declare that I shall be abided by the rules and regulations of the Centre.


Place :       

Enclosure: Final / Pre final Year Mark sheet copy

 
Signature of the candidate

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