GOVERNMENT OF PONDICHERRY DISTRICT INDUSTRIES CENTRE ***** APPLICATION FORM FOR COIR MASTER TRAINER 1. Name &Address : 2. Age & date of birth : 3. Educational qualification : 4. Whether belongs to SC/ST : Yes / No 5. Previous experiences in the field : 6. Whether he/she has been trained by this Centre ? if so furnish details : 7. Whether he/she has give Training Centre previous years, if so give details : 8. Name & address of the units : 9. Whether the unit has been permanently registered with Industries Department? if so attach a copy : 10. Any other details : Place: Date : SIGNATURE
