Name Name of Candidate * (In BLOCK LETTERS) As per School Leaving Certificate Email Address * Date of Birth Age Gender * Male Female Other 12 Digit Aadhaar No. * Name of Parent / Guardian * Occupation of Parent / Guardian Annual Income of Parent / Guardian Mobile No. of Candidate * Mobile No. of Parent / Guardian * Choose Exam Centre * Raebareli Lucknow Kanpur Prayagraj (Allahabad) Permanent Address * City & Pincode Landmark Address for Communication City & Pincode Landmark Education Qualification * 10th 12th ITI Other Which course(s) are you interested in? Pipe Fitter (City Gas Distribution) Pipe Fitter (Oil & Gas) Industrial Welder Process Instrument Operator Industrial Electrician Category General SC ST OBC EWS PH Other Form Submission Date I agree to all I confirm that the information given above is correct and true to my belief and knowledge.