Application Form by Ncvt

							                   No.


                      AMPERE TECHNICAL INSTITUTE & ITC
                                          PAYYANUR - 670 307
                                  KANNUR DT., KERALA STATE, PH: 207360
                                        (Affiliated to NCVT, Recognised by Govt. of Kerala)



 Course ....................................................                  Date .........................

                  APPLICATION FORM FOR ADMISSION

 1.   Name of the Candidate (in capitals)


 2.   Sex


 3.   Full Permanent Address
      (with pin & District) and Phone No.


 4.   Father’s / Guardian’s Name,
      Occupation and address and Phone No.


 5.   Age and Date of Birth (Evidence
      should be shown)


 6.   Community and Religion
      (If SC / ST produce Certificate
      from the authorities)


 7.   Qualification
      Marks obtained in SSLC

 8.   Trade in which candidate desires to be trained                 Ist Choice
                                                                     2nd ,,




                                                                                   Signature of applicant
NB: Attatch attested copy of SSLC.
                                                  DECLARATION

I.............................................................. son of ................................................
............................................................................................................................
hereby declare that shall by all the rules and regulations of the Ampere Technical
Institute and promise to remit all the fees prescribed at the time of admission in full or
in instalments.

      I accept all the decisions of the authorities in all matters of training, conduct
and discipline with no right of questioning any of them in any court of law.

Place:
                                                                                  Signature of Parent / Guardian

Date:


       I agree to the endorsement made above and accept the responsibility for the
applicant’s good conduct and regular payment of dues.

Place :
                                                                                 Signature of Parent / Guardian.

Date.


                                                  OFFICE NOTE

Fees received
      Date of joining
      Admission fee                                                                                 Affix Photo
      Tuition fee with receipt No.
      Caution deposit
Application processed and admission approved by




                                                                                                             PRINCIPAL
Remarks :

Date :