Form & Registration Fee @ Rs.

100/GOVERNMENT OF INDIA
MINISTRY OF LABOUR & EMPLOYMENT
ADVANCED TRAINING INSTITUTE
SION, MUMBAI 400 022

FOR OFFICE USE

1. Form No.
2. Regn No.
Dt.:
3. DD No.
Dt.:

AVTS BIODATA FORM

1.

Name (In Block letters)

:__________________________________________________________________

2.

Date of birth / age

:_______________Male/Female :_________ ST/SC/OBC/Gen/Others:_________

3.

Residential Address with :__________________________________________________________________

Telephone no.

__________________________________________________________________

E-mail Id _________________________________________Mobile No._____________________________

4.

5.

Academic Qualification (S.S.C./H.S.C./B.A./B.Com./B.Sc.) :Class / Std. Passed

Year of passing

Name of Board / University

Technical Qualification (National Trade Certificate/National Apprentice Certificate/DIPLOMA/DEGREE in Engineering Field):Name of Institute/College
Trade/ Diploma/Degree
Year of Passing
Duration of Course

6.

Practical Experience :Name of Employer

Nature of works done
/organization / company

Period
From
To

Gross
salary

Reasons for leaving /

changing the job.

7. AVTS Short-term Course in which admission is sought ( Separate Application is to be made for each course):Name of the Course
Duration in Weeks
From
To

Signature of Applicant __________________________

To

If sponsored, Name & address of the Sponsoring Authority :

Name & Address of Participant

______________________________________

____________________________________________
____________________________________________

______________________________________

________________________________________

______________________________________

Signature of Sponsoring Authority with stamp

______________________________________
Course Name___________________________
______________________________________
From ______________ to _________________

NOTE :1. Copy of Final year Technical education Marksheet/certificates

should be enclosed with the application form in proof of
experience and qualification.
2. The Form & Registration fee charges @ Rs.100/- should be payable
by DD in favour of The Director, ATI, Mumbai

Date : ______________

Place : _________________
ACKNOWLEDGEMENT

ADVANCED TRAINING INSTITUTE, SION, MUMBAI 400 022.

Received Form No.____________ & Registration vide No. _______________ dated __________________.
Also received Cash Receipt /DD vide No. _____________ dated ______________ @ Rs.100/- towards cost of
Form & Registration for AVTS short-term course on ___________________________________________________
form_____________ to _______________ Name of Applicant:__________________________________________
Signature with Official seal