|
|
To
Kshitij
|
Attach
Your
Two
Latest Passport Size
Photos.
Please
Do Not
Paste
it. |
Applicant's
Name:.............................................................................................................................
Father's/Husband's
Name:..................................................................................................................
Date
of Birth &
Place:................................................
Qualification:.....................................................
Occupation:..............................................................
Mobile :
..........................................................
Address :
.......................................................................................................................................
.....................................................................................................................................................
Email :
...........................................................................................................................................
I
hereby declare, the above mentioned facts are true to the best of my
knowledge. I agree to abide
by
the rules and regulations of the Kshitij.
Any
other information
:......................................................................................................................
.....................................................................................................................................................
.....................................................................................................................................................
I
herewith enclose Rs. 2000/- by cash or
D.D.
(in favour of “Kshitij”,
payable at New Delhi or Gurgaon)
Demand
Draft No. .............................
Dated ...............................
Signature of
Applicant
(Printout/ Copy/ Photocopy can be used.)
|
