SECTION - A Side - A Vocational/I.T.I. to Diploma Entrance...
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Application Form SECTION - A Side - A Vocational/I.T.I. to Diploma Entrance Competitive Examination - 2015 Name : ........................................................................................................................................................................................................ Father's Name : ......................................................................................................................................................................................... Address : ................................................................................................................................................................................................... ................................................................................................................................................................................................................... ...................................................................................................................................... Dist. .................................................................... State .......................................................................................................... Pin : SECTION - B 1. Name of the Candidate (as per 10th class records) 2. Father's Name (as per 10th class records) 3. Date of Birth 3. Date of Birth 4. Gender 4. Gender 5. Category 5. Category (Write the relevant code in the box) (Write the relevant code in the box) 6. Handicapped Male - M Female - F Male - M Female - F Gen - 1 BC-I - 4 SC - 2 BC-II - 5 ST - 3 Blindness - 1 Deafness - 2 ST - 3 SC - 2 BC-II - 5 Gen - 1 BC-I - 4 Phy. Hand.- 3 None - 4 Blindness - 1 Deafness - 2 Phy. Hand.- 3 None - 4 7. Mobile No. Year Month Date 12. Your Father / Guardian annual Income (Write the relevent code) Less than Rs. 2,00,001 - 1 In between Rs. 2,00,001 to Rs. 4,50,000 - 2 In between Rs. 4,50,001 to Rs. 10,00,000 - 3 Above Rs. 10,00,001 - 4 13. Application Fee details :- If candidate has submitted by Demand Draft In between Rs. 4,50,001 to Rs. 10,00,000 - 3 Above Rs. 10,00,001 - 4 Less than Rs. 2,00,001 - 1 In between Rs. 2,00,001 to Rs. 4,50,000 - 2 If candidate has submitted through Bank CHALLAN 1. Transaction ID: _________________________ 3. Deposit Date : _____ / _____ / 2015 2. Application Fee Amount: __________________ (Please ensure that CHALLAN Board's Copy is attached with Application Form) (Please ensure that Demand Draft in ORIGINAL is attached with Application Form) 14. Address for Correspondence (IN CAPITAL LETTERS) USE ONLY BLACK PEN 15. Signature of the Candidate 16. Paste Photograph within provided space 17. Left thumb impression Paste (Do not staple) your Non-attested Photograph Date Month Year -- -- -- -- Registration No. (Office use only) 1. Transaction ID: _________________________ 2. Application Fee Amount: __________________ (Please ensure that CHALLAN Board's Copy is attached with Application Form) 0 (See back side for Group Code i.e. Side-B) 6. Handicapped 11. Group Code of Vocational Course or I.T.I. Trade 10. M.C.Q. Quota (Muslim Community Quota) Yes - 1 No - 2 No - 2 Yes - 1 2. Father's Name (as per 10th class records) 1. Name of the Candidate (as per 10th class records) If candidate has submitted through Bank CHALLAN 1. Demand Draft No.: _______________________ 3. Deposit Date : _____ / _____ / 2015 2. Demand Draft Amount: ____________________ 1. Demand Draft No.: _______________________ 2. Demand Draft Amount: ____________________ If candidate has submitted by Demand Draft (Please ensure that Demand Draft in ORIGINAL is attached with Application Form) 8. AADHAR No. (If available) 10. M.C.Q. Quota 11. Group Code of Vocational Course or I.T.I. Trade 12. Your Father / Guardian annual Income (Write the relevent code) 13. Application Fee details :- 14. Address for Correspondence (IN CAPITAL LETTERS) USE ONLY BLACK PEN 15. Signature of the Candidate 16. Paste Photograph within provided space 17. Left thumb impression Vocational/I.T.I. to Diploma Entrance Competitive Examination - 2015 3. Deposit Date : _____ / _____ / 2015 3. Deposit Date : _____ / _____ / 2015 (See back side for District Code i.e. Side-B) 9. Correspondence Address PIN & District Code -- PIN Code District Code District Code PIN Code 9. Correspondence Address PIN & District Code
Transcript of SECTION - A Side - A Vocational/I.T.I. to Diploma Entrance...
Application Form
SECTION - A
SECTION - B
Side - A
Vocational/I.T.I. to Diploma Entrance Competitive Examination - 2015
Name : ........................................................................................................................................................................................................
Father's Name : .........................................................................................................................................................................................
Address : ...................................................................................................................................................................................................
...................................................................................................................................................................................................................
...................................................................................................................................... Dist. ....................................................................
State .......................................................................................................... Pin :
SECTION - B
1. Name of the Candidate (as per 10th class records)
2. Father's Name (as per 10th class records)
3. Date of Birth3. Date of Birth 4. Gender4. Gender 5. Category5. Category (Write the relevant code in the box)(Write the relevant code in the box)
6. Handicapped
Male - MFemale - FMale - MFemale - F
Gen - 1 BC-I - 4SC - 2 BC-II - 5ST - 3
Blindness - 1 Deafness - 2
ST - 3SC - 2 BC-II - 5Gen - 1 BC-I - 4
Phy. Hand.- 3 None - 4
Blindness - 1 Deafness - 2
Phy. Hand.- 3 None - 4
7. Mobile No.
YearMonthDate
12. Your Father / Guardian annual Income (Write the relevent code)
Less than Rs. 2,00,001 - 1 In between Rs. 2,00,001 to Rs. 4,50,000 - 2
In between Rs. 4,50,001 to Rs. 10,00,000 - 3 Above Rs. 10,00,001 - 4
13. Application Fee details :- If candidate has submitted by Demand Draft
In between Rs. 4,50,001 to Rs. 10,00,000 - 3 Above Rs. 10,00,001 - 4
Less than Rs. 2,00,001 - 1 In between Rs. 2,00,001 to Rs. 4,50,000 - 2
If candidate has submitted through Bank CHALLAN
1. Transaction ID: _________________________
3. Deposit Date : _____ / _____ / 2015
2. Application Fee Amount: __________________
(Please ensure that CHALLAN Board's Copy is attached with Application Form)(Please ensure that Demand Draft in ORIGINAL is attached with Application Form)
14. Address for Correspondence (IN CAPITAL LETTERS) USE ONLY BLACK PEN
15. Signature of the Candidate
16. Paste Photograph within provided space 17. Left thumb impression
Paste (Do not staple)your Non-attested
Photograph
Date Month Year
--------
Registration No.(Office use only)
1. Transaction ID: _________________________
2. Application Fee Amount: __________________
(Please ensure that CHALLAN Board's Copy is attached with Application Form)
0
(See back side for Group Code i.e. Side-B)
6. Handicapped
11. Group Code of Vocational Course or I.T.I. Trade10. M.C.Q. Quota(Muslim Community Quota)
Yes - 1No - 2No - 2Yes - 1
2. Father's Name (as per 10th class records)
1. Name of the Candidate (as per 10th class records)
If candidate has submitted through Bank CHALLAN
1. Demand Draft No.: _______________________
3. Deposit Date : _____ / _____ / 2015
2. Demand Draft Amount: ____________________
1. Demand Draft No.: _______________________
2. Demand Draft Amount: ____________________
If candidate has submitted by Demand Draft(Please ensure that Demand Draft in ORIGINAL is attached with Application Form)
8. AADHAR No.(If available)
10. M.C.Q. Quota 11. Group Code of Vocational Course or I.T.I. Trade
12. Your Father / Guardian annual Income (Write the relevent code)
13. Application Fee details :-
14. Address for Correspondence (IN CAPITAL LETTERS) USE ONLY BLACK PEN
15. Signature of the Candidate
16. Paste Photograph within provided space 17. Left thumb impression
Vocational/I.T.I. to Diploma Entrance Competitive Examination - 2015
3. Deposit Date : _____ / _____ / 2015 3. Deposit Date : _____ / _____ / 2015
(See back side for District Code i.e. Side-B)9. Correspondence Address PIN & District Code
--
PIN Code District CodeDistrict CodePIN Code
9. Correspondence Address PIN & District Code
Side - B Vocational/I.T.I. to Diploma Entrance Competitive Examination - 2015Vocational/I.T.I. to Diploma Entrance Competitive Examination - 2015
(11) Course's/Trade's name and their Group Code
Course's Name
Fitter, Turner, Mechanist, Mech. Motor Vehicle, Machinist Grinder, Mech. Ref. & Air ConditioningDraftsman Mechanical, Instrument Mech. Automobile Engg. & Tech., Production & Manufacturing
Electrical, Wireman, Electroplater, Electrician, Electrical Domestic Appliances
Surveyor, Draftsman Civil
Mech. General Electronics, Mech. Radio & TV, Mech. Consumer Electronics, Mech. Industrial
Group Code
1
1. Name of the Candidate: _________________________________________________________________
2. Father's Name: ________________________________________________________________________
3. Mother's Name: ________________________________________________________________________
4. Permanent Address: ____________________________________________________________________
________________________________________________________________________________________
Dist. : _________________________________ State: ____________________________________________
Tel. No. / Mobile No.: PIN No. :
5. Visible identification mark of the Candidate: __________________________________________________
6. Date of Birth
YearMonthDateDate Month Year
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7. Category (For statistical purpose) [ ]: GEN SC ST BC-I BC-II
8. Gender [ ]: Male Female
9. Declaration of the Candidate:
1. Name of the Candidate: _________________________________________________________________
2. Father's Name: ________________________________________________________________________
3. Mother's Name: ________________________________________________________________________
________________________________________________________________________________________
Dist. : _________________________________ State: ____________________________________________
Tel. No. / Mobile No.:
YearMonthDateDate Month Year
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GEN SC ST BC-I BC-II
Male Female
PIN No. :0
I hereby declare that informations furnished above are correct and all certificates in ORIGINAL are lying with me orI am able to procure required certificates and will be produced at the time of COUNSELLING. I shall forfeit my cand-idatures as well as liable for legal action in case any of them is proved to be false at any stage of ADMISSION orthereafter or if I will not produce relevant required ORIGINAL certificates.
11. Candidate's signature
4. Permanent Address: ____________________________________________________________________
5. Visible identification mark of the Candidate: __________________________________________________
6. Date of Birth
7. Category (For statistical purpose) [ ]:
8. Gender [ ]:
9. Declaration of the Candidate:
10. Father's / Guardian's signature10. Father's / Guardian's signature 11. Candidate's signature
Date:- _____ / ______ / 2015
Place:- _________________
Date:- _____ / ______ / 2015
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Electonics, Electronics Mechanic, Electronics Technology, Radio TV Technician
I.T. & E.S.M., Mech. Computer Hardware, Computer Science
Mining Geology
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(11) Course's/Trade's name and their Group Code
Course's Name
Fitter, Turner, Mechanist, Mech. Motor Vehicle, Machinist Grinder, Mech. Ref. & Air ConditioningDraftsman Mechanical, Instrument Mech. Automobile Engg. & Tech., Production & Manufacturing
Electrical, Wireman, Electroplater, Electrician, Electrical Domestic Appliances
Surveyor, Draftsman Civil
Mech. General Electronics, Mech. Radio & TV, Mech. Consumer Electronics, Mech. Industrial
Group Code
1
Electonics, Electronics Mechanic, Electronics Technology, Radio TV Technician
I.T. & E.S.M., Mech. Computer Hardware, Computer Science
Mining Geology
23
4
56
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Bank’s Copy
Challan for Vocational / I.T.I. to Diploma Entrance Competitive Examination – 2015 Application Form
Cash can be deposited at any Branch of United
Bank of India
A/c No. - 1842010000921 IFSC No. - UTBI0SCTQ03
Application Form Fee*:-
Gen/BC – I/BC - II [ ] ` 450/- ST / SC [ ] ` 275/- (Tick [ √ ] which is applicable)
* - Last date for submitting the Fee is 14.04.2015.
(To be filled up by the Depositor)
Candidate’s Name: ______________________
______________________________________
Category (mention your category): __________
Father’s Name: _________________________
______________________________________
Date of Birth: ___________________________
Mobile No. : ____________________________
Transaction ID: __________________________
NFFT / UTR No. (In case of IFSC):
_________________________
Deposit Date: ____ / ____ / 2015
Signature of Authorized Signatory & Depositor Seal
Candidate’s Copy
Challan for Vocational / I.T.I. to Diploma Entrance Competitive Examination – 2015 Application Form
Cash can be deposited at any Branch of United
Bank of India
A/c No. - 1842010000921 IFSC No. - UTBI0SCTQ03
Application Form Fee*:-
Gen/BC – I/BC - II [ ] ` 450/- ST / SC [ ] ` 275/- (Tick [ √ ] which is applicable)
* - Last date for submitting the Fee is 14.04.2015.
(To be filled up by the Depositor)
Candidate’s Name: ______________________
______________________________________
Category (mention your category): __________
Father’s Name: _________________________
______________________________________
Date of Birth: ___________________________
Mobile No. : ____________________________
Transaction ID: __________________________
NFFT / UTR No. (In case of IFSC):
_________________________
Deposit Date: ____ / ____ / 2015
Signature of Authorized Signatory & Depositor Seal
Board’s Copy
Challan for Vocational / I.T.I. to Diploma Entrance Competitive Examination – 2015 Application Form
Cash can be deposited at any Branch of United
Bank of India
A/c No. - 1842010000921 IFSC No. - UTBI0SCTQ03
Application Form Fee*:-
Gen/BC – I/BC - II [ ] ` 450/- ST / SC [ ] ` 275/- (Tick [ √ ] which is applicable)
* - Last date for submitting the Fee is 14.04.2015.
(To be filled up by the Depositor)
Candidate’s Name: ______________________
______________________________________
Category (mention your category): __________
Father’s Name: _________________________
______________________________________
Date of Birth: ___________________________
Mobile No. : ____________________________
Transaction ID: __________________________
NFFT / UTR No. (In case of IFSC):
_________________________
Deposit Date: ____ / ____ / 2015
Signature of Authorized Signatory & Depositor Seal
Jharkhand Combined Entrance Competitive Examination
Jharkhand Combined Entrance Competitive Examination
Jharkhand Combined Entrance Competitive Examination
Instruction for Candidate:- Submit the requisite Application Form fee and collect Board's & Candidate's Copy from Bank. Send the Board's Copy with the Application Form.Instruction for Candidate:- Submit the requisite Application Form fee and collect Board's & Candidate's Copy from Bank. Send the Board's Copy with the Application Form.
