Professional Documents
Culture Documents
(An undertaking of Government of Rajasthan & presntly Managed by Ambuja Educational Institute)
tick one)
4 Years Under Graduate Diploma
2.5 Years Post Graduate
Program in Craft Design
Diploma Program in
Fired Material Application
Furniture and Interior Products
Terracotta, Ceramics
Home Textiles
Floor coverings & furnishings
Instructions:
Please fill in BLOCK LETTERS in English or fgUnh with Black Ink/Ball Pen only.
DO NOT PIN/STAPLE
Last date for receiving completed application form is 20th May, 2011 at the above address.
The Application should be sent to Admissions Officer at the above address.
Enclose Mark sheet of the final examination.
the photograph
Paste the recent photograph
inside the box only
PHOTO NOT TO BE ATTESTED
ID:
(Middle Name)
(Last Name)
2. Date of Birth
(dd/mm/yy)
Age
(as on 1st January 2011)
3. Place of Birth
(Country)
(City)
(State)
4. Nationality
5. Marital Status
6. Category
Unmarried
SC
Gender (M/F)
Married
ST
OBC
Yes
General
No
8.
Yes
No
_____________________________________________________________________________________________________________
IICD gives preference to candidates from practicing craft families.
_______________________________________________________
_________________________________________________________
______________________________________________________
_________________________________________________________
______________________________________________________
_________________________________________________________
______________________________________________________
_________________________________________________________
Email ID______________________________________________
Email ID ________________________________________________
____________________________________________________
________________________________________________________
____________________________________________________
________________________________________________________
____________________________________________________
________________________________________________________
____________________________________________________
________________________________________________________
Email ID____________________________________________
Email ID _______________________________________________
Subjects
Board/School/College/University
Grade/Class/Division
2. Work experience (if any). List the most recent work experience first.
Year
Emoluments
3. State knowledge of Indian & Foreign Language (either fluently, reasonably, with difficulty)
Language Speak
Read
Write
Hindi
_____________________
_____________________
_____________________
English
_____________________
_____________________
_____________________
................
_____________________
_____________________
_____________________
................
_____________________
_____________________
_____________________
Declaration:
I declare that all the information provided herein is true and correct.
Signature of Candidate ___________________________________ Signature of Parent/Guardian________________________________
Place _________________________________________________ Date_____________________________________________________
Candidate Id:
Name: ___________________________________________________________________
DO NOT PIN/STAPLE
Program: _________________________________________________________________
the photograph
Paste the recent photograph
inside the box only
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
(Candidates Signature)
(Admissions Officer)
Name
Mode of issue of Application
Application No.
YES
NO