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10.

DECLARATION

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I declare that I fulfill the eligibility conditions as per the
are true, complete
and that all the statements made in this application
belief. I understand that in
and correct to the best of my knowledge and
false or incorrect at any stage
the event of any information being found
to the requirements
or not satisfying the eligibility conditions according
is liable to
mentioned in the advertisement, my candidature/internship
be cancelled/ terminated.

Aushi
siGNATURE

PLACE..uckMDkil uushi rsuah


DATE JG.p202 (NAME OF THE APPLICANT)

Note: The following documents should be sent along with the application.

(i) A copy each of the certificates duly self attested in support of relevant
information may be attached.
are required to also submit a Statement of Purpose in about
(i) Applicants
two hundred words along with the application.
APPLICATION FOR LOK SABHA TRAINING PROGRAMME ON
INNOVATION, RESEARCH AND DEVELOPMENT (LSTPIRD)

1. Candidate Name:
Atsht...angh.
2. Father'sName: ViHes.h...Mohakn.xuh.
3. (a) Preset Address:. .!AS..nskt..ALgaM...
(b) Permanent Address:i.s..LackunGL..aga
() State: ious..Luaclesh
(a) E-mail Address: ..4LLshisingho246.8.raul. com
(b)Mobile Number: .30.3.80.H.OOI....
4. (a) Date of Birth: Q.0413000. (b) Age as on (a2.yecuis)
5. Academic Qualifications: (Including professional/technical qualification, if any)

s.No. Qualification Degree Board/Universityy Subjects Year of of Division


Studied Passing Marks Obtained

Ligh Sehool Bacly mp CSE


ol6 33/ B
neumedate IcseBocvd) do18757.B
3 GradlualonBomuckno
LHons)
o Unurs

Pursuing Course...om Hons)


EuKSBBausuussuusnanhusst seuuraaurnneu
a amasasmouB

6. Languages Known..ngksh,tlincl. **n***

7. Details of artides/publications, if any


8. Proficiency in computer applications Jes, oell wonseck
9. Professional experience, if any (In case the
**

applicant is working with any Government


Organisation, the application shall be routed through the proper channel)

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