BOARD OF APPRENTICESHIP TRAINING
(Northern Region)
16, 1-A, Lakhanpur, Kanpur - 208024
APPLICATION FOR APPRENTICESHIP UNDER APPRENTICES ACT 1961.
(For use by old  passed out candidates only (Upto last three years ))

(A candidate should attach attested copies of final year  marksheet of Engg. Degree/Diploma, 

High school Certificate and  an  affidavit by a notary indicating that he has not  undergone

 any training or job  after completion  of  Engg. Degree/Diploma)

1. Name of Candidate (In Block Letters) ..................................................................................................................

2. Father's Name ...........................................................................................................................................................

3. Address for correspondence..........................................................................................

.............................................................................................................................................

4. Date Of Birth ................................Age..........       Male/Female.............................................

5. Scheduled Caste / Tribe (Give Details) ....................................................................................
6. Particulars of Final Engineering/Diploma Examination Passed:--

Degree/ Diploma

Branch of
Engg./Tech.

Institution from
where passed

University/
Board

Year of
passing

Marks Obtained/
Max. Marks

% of Marks

 

7. Have you passed above examination under sandwich Course, if yes, give details.

Name & Address of the establishment where placed for training

Date of Joining/Release  

              Place of work   .                                      
 

 

    

 

8. Experience (if any) :
Name of Employer Designation Date of Joining/Release Reason of release
 

 

      
9.  Have you ever applied for Apprenticeship under the act, if yes, please give details: 

10. Have you ever undergone training under the Apprentices Act-1961, if yes, give details :

11. Choice of training place:...........................................................

       I certified that the details given above are correct and I do not have training/job 

experience after passing Degree/Diploma Examination. In case any information is 

found false, I shall refund  the training cost and suitable action may be taken against me.
                                                                                                           

Date :                                                                                                   Signature of Candidate

 

FOR USE BY THE OFFICE OF THE BOARD OF APPRENTICESHIP TRAINING(NR)  KANPUR-24

Date Recd.

Computer code no.

Interview

No.

Date

Establishment Offered