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7 views2 pages

Form

Uploaded by

GANESH R
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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CA:F:APP:002 rev4

CORNERSTONE ACADEMY Pvt. Ltd.


Plot No:98, 1stStreet, Viduthalai Nagar, S.Kolathur
off Thoraipakkam-Pallavaram 200’ Road, Kovilambakkam
CHENNAI–600 117. Mob : 9840855583, 9952949213
E-MAIL: [email protected], website : www.cornerstoneacad.com

APPLICATION FORM FOR COURSE REGISTRATION


(PLEASE FILL IN BLOCK LETTERS)
Applying for: _______________ (Specify IWE/IWT)
(IWE: INTERNATIONAL WELDING ENGINEER
IWT: INTERNATIONAL WELDING TECHNOLOGIST)

1. Name: _______________________________________________ Paste recent


2. Photo Identity number: ________________________________ passport
(Aadhar / Driving license / Passport) Photograph

2. Self-Sponsored Company Sponsored


3. Father’s name: ________________________________________
4. Date of Birth: _________________________________________
5. Present Address: _____________________________________
__________________________________________________________________________
______________________________________________Pincode:_____________________
6. Permanent Address: ______________________________________________________
__________________________________________________________________________
______________________________________________Pincode:_____________________
Email:____________________________________ Mobile number:__________________
(Kindly fill your personal email ID) WhatsApp number:__________________
7. Academic Qualification:
(Self-Attested copies of Certificates and consolidated Mark sheets must be enclosed with
this form in order)

Examination Passed Board/Institute’s Year of % of Marks


name passing

A.

B.

1
CA:F:APP:002 rev4

C.

D.

E.

8. Work Experience:
Name of Organization Post held and Job Years of Experience
(Latest first) description
A.

B.

C.

 The following attested Xerox copies of certificates should be attached as per the
below mentioned order along with this form.
 Photo ID proof copy. ( )
 10th std mark sheet. ( )
 12th std mark sheet. ( )
 Diploma certificate & consolidated Marksheet ( )
 B.E degree certificate & consolidated marksheet ( )
 P.G degree certificate. (if applicable) ( )
 Work experience certificates if any ( )

DECLERATION
I………………………………… hereby declare that all the certificates and information
attached are original and true to my knowledge.

Place:……………….. [ ]
(current location)
Date:…………… Signature

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