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  • Directorate of Vocational Education and Training, Maharashtra State, Mumbai - 1 Grievance Application Form

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    LuckyJackson
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    This document is a registration form for admission to a Government Industrial Training Institute program in Maharashtra, India. It requests information such as the candidate's name, religion, gender, educational qualifications, disabilities, and subject scores from SSC (10th standard). Fields that are already correctly filled should not be written in. The form needs to be verified and accepted or not accepted by an officer.

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    Grievance Form

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    This document is a registration form for admission to a Government Industrial Training Institute program in Maharashtra, India. It requests information such as the candidate's name, religion, gender, educational qualifications, disabilities, and subject scores from SSC (10th standard). Fields that are already correctly filled should not be written in. The form needs to be verified and accepted or not accepted by an officer.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    4 views1 page

    Directorate of Vocational Education and Training, Maharashtra State, Mumbai - 1 Grievance Application Form

    Uploaded by

    LuckyJackson
    This document is a registration form for admission to a Government Industrial Training Institute program in Maharashtra, India. It requests information such as the candidate's name, religion, gender, educational qualifications, disabilities, and subject scores from SSC (10th standard). Fields that are already correctly filled should not be written in. The form needs to be verified and accepted or not accepted by an officer.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Government of Maharashtra

    Directorate of Vocational Education and Training, Maharashtra State, Mumbai - 1


    Admission to Government Industrial Training Institute !road !ased !asic Training under "enter of E#cellence
    G$IEVA%"E A&&'I"ATI(% )($M

    Registration Number: _______________________
    Name of Candidate: ________________________ ________________________ _______________________________
    First Name Last Name (Surname) Middle Name (Father Name)

    Candidates should enter only those fields which have to be corrected. Kindly do not write/enter in those fields which are
    already correctly registered.
    l 4ll l lldl d 4lll 94d l 4lldl lldl d 4"ld ll. 4lld l lldl
    l l l 4ll l lldl 4 .

    S*%* &articulars Entered Actual S*%* &articulars Entered Actual
    01 $eligion (BuddhistChristian!indu
    Muslim"ainSi#h$arsi%ther)
    0& "ategor+ (SCS'("N')BN')C
    N')*SBC%$+N%BC)

    0, Gender (Male Female) 0- Dra,ing Grade E#am (.esNo)
    0/ SS" Technical (.esNo) 00 -S" Vocational (.esNo)
    01 S.orts &erson (.esNo) 02 E#-Service Man (.es No)
    Name of S3ort Ser4i5e 6ing (7ir For5e 7rm8Na48)
    6inning $osition $ost (Commissioned %ffi5erNon
    Commissioned %ffi5erLo9er Ran#)

    S3ort Le4el: National State*istri5t Ser4i5e $eriod (in months)
    0: &ro/ect Affected (.esNo) 10 Earth0ua1e Affected (.esNo)
    11 %on-"ream+ 'a+er (.esNo) 1& !olster School (.esNo)
    1, Defense "ategor+ 23es%o4
    +;)Ser4i5eman 9ith / 8ears e;3erien5e 6ard of <n)Ser4i5eman
    6ard of *efense %ffi5er 6ard of 6ar *eath 6ar !andi5a33ed
    6ard of +;)Ser4i5eman
    1- &erson ,ith Disabilit+ .+S N% *isabilit8 $er5entage
    T+.e of Disabilit+
    Blind Blindness
    *efe5ti4e Sight
    Lo9 (ision
    *eaf and *um3
    *eaf
    *eaf and *um3
    *efe5ti4e !earing
    Negati4e Le3ros8
    Res3irator8 *isable
    %rtho3edi5s: Both 7rms
    Both 7rms = Legs 7ffe5ted
    Both Legs affe5ted but not arms
    Le3ros8 Cured
    Limb <n>ur8 $olio $aral8sis
    Mentall8 Retarded
    %ne 7rm 7ffe5ted
    %ne Leg 7ffe5ted
    %ther %rtho3edi5 *isabilit8
    %ther *isabilit8


    Sub/ect 15
    th
    Standard %ational (.en Schooling-andica. School
    Entered Actual Sub/ect Entered Actual
    MarathiRegional Lang Sub>e5t 1
    +nglish Sub>e5t &
    !indiSans#rit Sub>e5t ,
    Maths Sub>e5t -
    S5ien5e Sub>e5t /
    So5ial S5ien5e Sub>e5t 0 (0?1?so on)


    *ate: ___ 01 &01- Signature of Candidate
    _________________________________________________________________________________________________________
    )or (ffice 6se7
    1@ *o5uments 4erified: .es No
    &@ Arie4an5e: 755e3ted Not a55e3ted
    ,@ <f Arie4an5e a55e3ted then: B3dated Not B3dated Form

    *ate: ___ 01&01, Name of %ffi5er:_______________________ *esignation: _____________________________

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