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Dks'Ky Izf'K (K.KKFFKZ Ksa Ds Fy S Iathdj.K DK Izi : Jharkhand Skill Development Mission

This 3 sentence summary provides the key details about the document: The document is a registration form for skill trainees in Jharkhand Skill Development Mission, an autonomous institution under the Department of Planning and Development. The multi-page form collects personal details of applicants, including name, photo, address, education level, family income, occupation, and skill training preferences based on enclosed lists of skill sectors and job roles. Applicants, sponsors, and registration officials are required to sign the form.

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Kumar Udit
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39 views

Dks'Ky Izf'K (K.KKFFKZ Ksa Ds Fy S Iathdj.K DK Izi : Jharkhand Skill Development Mission

This 3 sentence summary provides the key details about the document: The document is a registration form for skill trainees in Jharkhand Skill Development Mission, an autonomous institution under the Department of Planning and Development. The multi-page form collects personal details of applicants, including name, photo, address, education level, family income, occupation, and skill training preferences based on enclosed lists of skill sectors and job roles. Applicants, sponsors, and registration officials are required to sign the form.

Uploaded by

Kumar Udit
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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JHARKHAND SKILL DEVELOPMENT MISSION

(An Autonomous Institution under the Deptt. of Planning and Development)


230-B, Road No. 2, Ashok Nagar, Ranchi - 834002
E-mail : skilljharkhand@gmail.com Website : www.skilljharkhand.org

Form No.
dkS'ky izf'k{k.kkfFkZ;ksa ds fy;s iathdj.k dk izi=
Skill Trainees Registration Form

Paste
1. O;fDrxr fooj.k / Personal Details Photograph
1.1 uke @ Name rLohj fpidk;sa
1.2 firk dk uke @ Father's Name
1.3 tUe dh frfFk @ Date of Birth
1.4 oxhZdj.k ( fpUg yxk;sa) (lkekU; @ Gen) (vU; fiNM+k oxZ @ OBC)
Category Please Tick () (vuqlwfpr tutkfr@ ST) (vuqlwfpr tutkfr @ SC)
1.5 vYi la[;d @ Minority gk¡ ugha
1.6 fyax ( fpUg yxk;sa) @ Gender () efgyk iq:"k mHk; fyax
1.7 fu%'kDrrk @ Disability ( fpUg yxk;sa) gk¡ ugha fu%'kDrrk dk izdkj
1.8 eujsxk @ vU; ;kstuk ds ykHkkFkhZ mldk mYys[k djsa
Bene ciaries of MGNREGA / Bene ciaries of other
schemes, Pl. specify
iath;u la[;k @ Registration No.
1.9 vk/kkj dkMZ la[;k @
Aadhar Card Number
() fpUg yxk;sa @ Please (ch0ih0,y0 @ BPL)
Tick () BPL / APL (,0ih0,y0 @ APL)
ch0ih0,y0 la[;k @ BPL No.
2. vkoklh; irk / Residential Address
2.1 vkokl la[;k @ House No.
iFk @ Lane / Street
2.2 xzke @ Village
xzke iapk;r @ Gram Panchayat
iz[k.M @ Block
2.3 Mkd ?kj @ Post O ce
Fkkuk @ Thana
2.4 ftyk @ District
fiu dksM @ Pin Code
2.5 eks0 @ nwjHkk"k @ Mobile / Ph. No.
2.6 bZ&esy @ E-mail-ID :
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3. Hkk"kk,¡ / Languages
3.1 ekr` Hkk"kk @ Mother Tongue
vU;kU; Hkk"kk @ Other Language
4. 'kS{kf.kd ;ksX;rk,¡ / Educational Quali a dk % ) @ Please tick () & Mark (%)
cation ( fpUg yxk;as ,oa vd
4.1 vf'kf{kr@ Illiterate
4.2 (uu eSfVªd --------------------- d{k rd @ Non Matric ................................ Upto Class)
4.3 (eSfVªd --------------------------- @ 10th .............................................%)
laLFkku @ fo|ky; (Institution / School) -
4.4 (bUVj @ 12th ........................................................... %)
laLFkku @ fo|ky; (Institution / School) -
4.5 (Lukrd@ Graduate ............................................... %)
laLFkku @ egkfo|ky; (University / College) -
4.6 (LukrdksÙkj@ P.G. .................................................. %)
laLFkku @ ;qfuoflZVh (University / College) -
5. ikfjokfjd is'kk ,oa vk; / Family Occupation & Income
5.1 ikfjokfjd is'kk d`f"k @ Agriculture ukSdjh @ Service
( fpUg yxk;sa) futh O;olk; @ Self Occupation vU;kU; @ Other
5.2 Family Occupation vU;kU; mYys[k djsa @ Mention Other
5.3 Please Tick () okf"kZd vk; @Annual Income Rs:
6. vkosnd dk orZeku is'kk ,oa vk; / Family Occupation & Income
6.1 orZeku is'kk / Present Occupation
6.2 dk;kZuqHkou (eghuk @ o"kZ)
Work experience (months / years)
6.3 okf"kZd vk; @ Annual Income Rs :
7. visf{kd dkS'ky izf'k{k.k / Skill Training Required
7.1 Identify skill Sector as per list
enclosed / dkS'ky iz{ks= dk mYys[k dksM
djsa (layXu lwph ds vuqlkj) lwph ls (layXu lwph ds vuqlkj)
fHkUu gks] rks Li"V djsaA lwph ls i`Fkd gks] rks dksM 'NOO' fy[ksaA
7.2 Identify skill Job Role as per list
enclosed / tkWc jksy dk mYys[k djsa dksM
(layXu lwph ds vuqlkj) lwph ls fHkUu (layXu lwph ds vuqlkj)
gks] rks Li"V djsaA lwph ls i`Fkd gks] rks dksM 'NOO 1' fy[ksaA
iath;u izHkkjh dk gLrk{kj izk;kstd dk gLrk{kj izf'k{kkFkhZ dk gLrk{kj
Signature of Registration In-Charge Signature of Sponsor Signature of Trainee

uke uke uke


Name Name Name
in uke in uke in uke
Designation Designation Designation

LFkku frfFk LFkku frfFk LFkku frfFk


Place Date Place Date Place Date

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