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HMI Application Form for Mountaineering Courses

1. The document is an application form for mountaineering courses at the Malayan Mountaineering Institute in Darjeeling, India. 2. It requests basic information from applicants such as name, address, date of birth, contact details, academic qualifications, emergency contact, and confirmation of Indian nationality. 3. Applicants must also specify the serial number and fees for the course they are applying for, whether it be basic, advanced, instructor or adventure training, and provide details of any previous mountaineering experience or qualifications.

Uploaded by

Soumya Mariner Dutta
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76 views1 page

HMI Application Form for Mountaineering Courses

1. The document is an application form for mountaineering courses at the Malayan Mountaineering Institute in Darjeeling, India. 2. It requests basic information from applicants such as name, address, date of birth, contact details, academic qualifications, emergency contact, and confirmation of Indian nationality. 3. Applicants must also specify the serial number and fees for the course they are applying for, whether it be basic, advanced, instructor or adventure training, and provide details of any previous mountaineering experience or qualifications.

Uploaded by

Soumya Mariner Dutta
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

HI

MALAYANMOUNTAI
NEERI
NG I
NSTI
TUTE
JAWAHARPARBAT,DARJEELI
NG 734101
AFFI
X
PHOTO

APPLI
CATI
ONFORM

1. Name ..
(IN BLOCK CAPITALS)
2.

Permanent Address .
.
.
Phone no. .. Pin code ..

3.

Date of Birth Age on the date of application .

4.

Serial No. of the Course to be attended


BASIC / ADVANCE / MOI / ADVENTURE COURSE (Tick the correct one) Ser No )

5.

Full Course Fee Rs enclosed by Draft No .. Dt .

6.

Academic Qualification ..
Any special qualification or hobbies connected with mountaineering including courses, if any, attended
earlier.
(a) ...
(b) ...

7.

Next of Kin with address & Telephone / if any.


..
..

8.

In case of any injury etc, that may sustain during the period of training. I will not hold HMI responsible
for the same. I want to undertake the course as per my own will.
The above entries have been made by me and are true and correct.

Date..

_______________________
Signature of the applicant
Guardian ( in case of minor )

Nationality .
( in case of private candidate it must be certified by a Sub-Divisional Magistrate / Gazetted Officer )
Certified that I know the applicant and confirm that he/she is an Indian National.

Date...

________________
Signature

Place..

Seal

Designation.....................

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