ELECTRONICS SERVICE AND TRAINING CENTRE
(Under Ministry of MSME, Government of India)
Kaniya, Ramnagar, Nainital (Uttaranchal), India, PIN: 244 715
TEL:+91-5947-251201,251530       FAX: +91-5947-251294
 
REGISTRATION FORM

             For provisional admission kindly submit this form through postal mail duly filled. However admission will be confirmed through email / post on receipt of tuition fee & course material cost (through DD in favour of Principal Director, ESTC & payable at SBI (Code 0701) Ramnagar, Uttarakhand), along with this registration form duly signed, attested copies of certificates in proof of qualification, category, experience etc and two passport size photograph.

Name of the Course & Date 

1. Name of the applicant  
2. Father's Name              
3. Date of Birth                               4. Sex
5. Postal Address:
6. Telephone/Fax: 
7. E-mail :                
8. Category   
9. Name of the sponsoring organization (if any)
10. Tution Fee remitted Rs. DD No. Dated
11. Academic/Professional qualification :
Name of the exam passed Total % marks obtained

Subjects

 Name of the School/College Name of the Univ./Board

12. Professional Experience (if any)  


13.  UNDERTAKING:
                    I hereby undertake that in the event of unforeseen circumstances if Training program is cancelled /postponed I shall abide by the decisions of ESTC. However, I understand that in case programme is cancelled, the fee deposited by me will be refunded to me. The fee will not be refunded/transferred to other course in the event of not joining the course/leaving the course in between due to personal reasons or act of indiscipline.

List of Encl:                                             Sign. of Candidate :......................

Sign. of Course Co-ordinator.................                                                        Director (Trg.) :...........................

  




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Copyright © 2004 Last modified:  September 05, 2009

Web Site Designed and Maintained by :  D.S. Rawat, Scientific Officer