ONLINE APPLICATION FOR TRAINING

Name of the candidate

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Name of Father/Spouse

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Date of Birth

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X
SunMonTueWedThuFriSat

Sex

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Permanent Address
Village and Panchayat

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Block and /or Tehsil

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District

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State

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PIN Code

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Address for Correspondence

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Educational Qualification
Name of the Degree/Diploma/Certificate/Course

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Specialisation

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Board/Institute/University where studied

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University to which Affiliated

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Marks/Grade Obtained

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Year of Passing/completion

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Contact details
Telephone with STD Code/Mobile

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Email

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Aadhar Card No.

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Name of the Bank

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Branch Name

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Account Number

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IFSC Code

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Experience (maximum 200 characters)

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Family Background
Agriculture

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Other than agriculture

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Agri-Business interest
Nature of enterprise being planned to set up after the training

 (maximum 200 characters)

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experience in the enterprise being planned

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Likely place of establishment of enterprise

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Aptitude for extension work with brief details of extension work done and vision for future in serving farmers. (maximum 200 characters)

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