INDIRA GANDHI CENTRE FOR ATOMIC RESEARCH, KALPAKKAM

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Application for the position: APPRENTICE Passport size
photograph
Application Registration Number: 5360
Application Submitted: 12/04/2019 13:57:20

1. Trade Applied for : Fitter

2. Apprentice Registration Number : A101861830
3. Name : ANIL PASWAN
4. Mother's Name : SHANTI DEVI
5. Father's / Husband's Name : NAGESHWAR PASWAN
6. Date of Birth : 10/10/1994
7. Nationality : INDIAN
8. Gender : MALE
9. Marital Status : UNMARRIED
10. Category : SC
11. Physically disabled : NO
Nature of disability :
Percentage of disability :
12. AADHAAR Number : 612763140478
13. Permanent & correspondence address
Permanent address : VILL-NAWADADHI, SABERA EAST, GOMIA,
BOKARO, JHARKHAND
Pin Code: 829112
Address for correspondence : VILL-NAWADADHI, SABERA EAST, GOMIA,
GOMIA, JHARKHAND
Pin Code: 829112
14. E-Mail ID : anil.jordan420@gmail.com
15. Mobile No. : 8210629985
16. Phone No. : 8538926746
17. Educational Qualifications:
Examination Board/ Year of Obtained Total Marks Percentage
Passed Institution passing Marks
SSC /10th Std. JHARKHAND 2010 336 500 67.2
ACADEMIC
COUNCIL
RANCHI
HSC /12th Std. JHARKHAND 2012 241 500 48.2
ACADEMIC
COUNCIL
RANCHI
ITI NCVT 2018 2212 2700 81.9259
ITI Trade Fitter
ITI Certificate NCVT ITI Certificate 182040000010807
Type Number

18. Under Contractual Obligation : NO

 Contractual Obligation Details :
19. Underwent Apprenticeship training : NO
Apprenticeship training Details :
20. Interview Date : Will be announced later through Email / SMS
21. Additional Information :

Declaration
I hereby certify that the above stated information is factually correct to the best of my knowledge
and belief. I have not supressed any information and in case I gave any false information or
supressed any fact, then, my fellowship would be liable for termination without any notice or
reasons thereof.

Signature of the candidate

Name of the Candidate : ANIL PASWAN
Application Registration Number : 5360
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 CHECK LIST FOR THE CANDIDATES

(Say Yes/No against each column)

01. Copy of application completed and attached : __________

02. Affixed a passport size photograph in the space provided in application : __________

03. Application signed : __________

04. Original and Self attested copy of each of the following certificates is
attached

(a) Date of birth certificate : __________

(b) Community certificate in the prescribed format : __________

(c) All Education certificates : __________

(d) ITI Mark sheet and NCVT/SCVT Certificate : __________

(e) AADHAAR card : __________

(f) Proof of Mother’s Name : __________

(g) Confirmation copy of Apprentice Registration through Apprentice : __________

portal www.apprenticeship.gov.in

(h) Experience Certificate / Any other relevant certificate : __________

Signature of the candidate

Name of the Candidate : ANIL PASWAN
Application Registration Number : 5360
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