Pl. Paste Recent Passport Size Photograph

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Application for 1 Year CA/CMA Industrial Training (Strike out whichever is not applicable)

Name : ……………………………………………………………………

Registration No : …………………………………………………………………
Pl. paste recent
Father’s Name : …………………………………………………………………… passport size
photograph
Mother’s Name : …………………………………………………………………..

Date of Birth : ……………………………………………………………………

Correspondence Address : ……………………………………………………………………

…………………………………………………………………….

Email Address : ……………………………………………………………………

Mobile Number : ……………………………………………………………………

PAN Number : ……………………………………………………………………

Adhaar Number : ……………………………………………………………………

Education Qualification :
Qualification Board/Institute/University Year of Passing % of Marks Specialization
12th
Graduation

Professional Qualification (Please provide level wise information) :


Level Institute Month & Year of % of Marks No of
(ICAI/ICMAI) Passing Attempts
CPT/Foundation
Intermediate Group - I
Intermediate Group – II
Intermediate Group I&II
(If passed together)

Details of Articleship :
Firm Name Firm Address From To Remaining period of
Articleship

Choice of Work Centres for training: 1…………………….., 2 ……………………………, 3 ………………………………

Are any of your parents working/worked in ONGC (Pl. tick): YES/NO. If yes, please provide following:

Name………………………………………………………Relation………………………………CPF No ……………………………

I, hereby undertake that the particulars given by me are true to the best of my knowledge.

Signature of the applicant


Date:

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