PROCESS AND PRODUCT DEVELOPMENT CENTRE (MINISTRY OF MSME, GOVT.

OF INDIA,) FOUNDRY NAGAR, AGRA 282006 Phone: (0562) 2344006, 2344673 TeleFax: (0562)- 2344381 Visit: www.ppdcagra.in, E-mail: ppdc @ sancharnet.in Form No.: Past recent passport size photograph (Signature of applicant) APPLICATION/ REGISTRATION FORM CAD/CAM TRAINING CENTRE

1. 2. 3. 4.

Name of the Participant/ (Nominee & Description) Date of Birth Fathers Name Address for correspondence

: : : :

Phone. .E-mail 6 Months 3 Months ( ( ( ( ( ( ) ) ) ) ( ) ) )

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Course Applied for Master CAD/CAM Advanced CAD/CAM *AutoCAD *I-deas ) *Pro-E *Catia *Unigraphics *Ansys

CAD/CAM Courses

Duration Duration

(10.00A.M. to 4.00 P.M.) (7.00 A.M. to 7.00 P.M.) Duration 1 Month Duration 1 Month Duration 1 Month Duration 1 Month Duration 1 Month Duration 1 Month .. . (

( )

*or other certificate courses *Batch timings I Batch 7.00A.M. 10.00 A.M. ) 6. 7. Name of the Sponsoring Org. With S.S.I. Reg. (if sponsored) Educational Qualifications

),

II Batch, 4.00P.M. 7.00 P.M. (

: :

8. 9.

Experience ( if any ) Certificates Enclosed:

) ) ) ) (

1. S.S.C. (

2. Degree/Diploma/Equivalent ( 3. Others ( 4. One Photograph 5.

DECLARATION I do hereby declare that all the statements made in the application are true and correct. In the event of my information being found false, incomplete, incorrect or concealing the facts, my candidature may be cancelled at any stage without any notice. I have also fully gone through the course contents and understood that it is an introductory course covering basic concepts. I also understood that in any event the course fee paid by me will not be refunded transferred, adjusted for any other course or duration.

Date : Signature of the participant/Nominee