APPLICATION FORM FOR AFFILATION

 

Institute Location :

Study Centre Applied For
State  
City / Town / Village  

Institute Information :

Name of the Institute Year of Establishment Status of The Institution
P.O. P.S. Pin
Postal Address of the Institute    
   
Institute Contact No.
Phone1 Email Address

Information About Centre Head :

Name of the Centre Head State District
P.O. P.S. Pin
Postal Address of the Centre Head Contact No Educational Qualification
 

Details of Available Facilities of the Centre :

No of Computers No of Sewing Machines Other Machines/ Equipments
Internet Facility Inverter / Generator Facility Drinking Water Facility
 

Upload Documents :

Picture of Center Head
Aadhar Card/Voter Card of Center Head
Pictures of Center
I hereby certify that the context stated above are correct and true to my knowledge and belief and hereby confirm that our Organization / Society / Trust is free from any legal / official disputes whatsover.I accept that any facts stated above. I found incorrect will automatically result in cancellation for nominations associate.However I will have no right whatsover to fight / challenge legally against the judgment in any court of law. All disputes are subject to Nadia Jurisdiction only.