Training Pre-Registration Form

Trainee´s Name

First Name ^*

Middle Name

Last Name ^*

Guardian´s Name

First Name ^*

Middle Name

Last Name ^*

Personal Info

Relationship with guardian ^*

Date of Birth^*

Premises/house no

Village/Road ^*

Post Office ^*

Police Station ^*

City/Town ^*

State ^*

District ^*

Economical Status ^*

Residential Status ^*

Contact Info

Mobile No ^*

Alternate Ph No

Email ID

Self Declaration

I hereby declare that, all information provided by me are true to the best of my knowledge and nothing has been concealed therein. PBSSD may reject my application at any point of time, if the information provided by me found not true.

Accept Self Declaration

Utkarsh Bangla

Paschim Banga Society for Skill Development (PBSSD)

An Initiative by Department of Technical Education, Training and Skill Development

Government of West Bengal

Training Pre-Registration Form

Self Declaration