Page 72 - SW PROJECT
P. 72
Full address
Present Permanent Photo (duly
attested by
................................................................... .................................................................................
Gazetted Officer
.................................................................. ..................................................................................
.................................................................. ..................................................................................
District.................................................Pin District...................................Pin..............................
2. Particulars of course:
a) Name of course of study : ..........................................................
b) Name of Institution : ..........................................................
c) Name of accredited University : .........................................................
d) Whether recognised by IMC/
AICTE/UGC (specify) ............................................................
e) Duration of the course : ............................................................
f) Date of commencement of course : ...........................................................
g) Date of completion of course : ...........................................................
h) Job opportunities & expected monthly : ...........................................................
Income of student after completion
of the course
3. Particulars of parent/Guardian
a) Full name : ..........................................................
b) Permanent address (Residence) : ...........................................................
: ...........................................................
: ...........................................................
: ..........................Pin............................
c) Address: Place of work/ : ...........................................................
Employer's address : ...........................................................
: ...........................................................
: ...........................................................
d) If self employed, specify vocation : ...........................................................
: ...........................................................
e) Phone Number : ...........................................................
f) Age : ............................................................
g) Date of Superannuation : ............................................................
(in case of service)
h) Gross Annual Income : .............................................................
i) Particulars of deduction from
Gross income : ...............................................................
66 കേരള സംസഥന ആസത്ണ ക�ഥർഡ്
