Online Admission Application | SHAILDEVI PRIVATE ITI

1 Application Information (आवेदन विवरण)

Admission For / Trade (व्यवसाय) *

Academic Session (शैक्षणिक सत्र) *

Batch Preference (बैच)

2 Personal Information (व्यक्तिगत विवरण)

Full Name (आवेदक का पूरा नाम) *

Aadhaar Number (आधार कार्ड नंबर) *

Blood Group (रक्त समूह)

Mother's Name (माता का नाम) *

Father's Name (पिता का नाम) *

Father's Occupation (पिता का व्यवसाय)

Annual Family Income (वार्षिक आय)

Date of Birth (जन्म तिथि) *

Age (आयु)

Sex / Gender (लिंग) *

Marital Status (वैवाहिक स्थिति)

Religion (धर्म)

Caste (जाति)

Category (वर्ग) *

3 Address Details (पता विवरण)

Local / Correspondence Address (वर्तमान पता) *

Permanent Address (स्थाई पता) * Same as Local

4 Contact Information (संपर्क विवरण)

Student Mobile No. (छात्र मोबाइल) *

WhatsApp Number *

Father's Mobile No. (पिता मोबाइल)

Mother's Mobile No. (माता मोबाइल)

Email Address (ईमेल)

5 Facilities & Special Category (सुविधाएं एवं विशेष श्रेणी)

Physically Handicapped? (दिव्यांग)

Handicap Details (यदि हाँ, विवरण)

Hostel Facility Required? (छात्रावास)

Transport Facility? (बस / आवागमन)

6 Bank Account Details for Scholarship / DBT (बैंक खाता विवरण)

Bank Name (बैंक का नाम)

Branch Name (शाखा का नाम)

Account Number (खाता क्रमांक)

IFSC Code (आई.एफ.एस.सी. कोड)

7 Academic Qualifications (शैक्षणिक योग्यता)

Exam (परीक्षा)	School / Board (संस्था / बोर्ड)	Year	Roll No	Max Marks	Marks Obt.	% / CGPA
10th / High School *
12th / Higher Secondary
Graduation (स्नातक)
Post Graduation / Others

8 Document Uploads & Enclosures (संलग्नक दस्तावेज)

1. Passport Size Photograph *

2. 10th Class Certificate / Marksheet *

3. 12th Certificate (If applicable)

4. Aadhaar Card (Identity Proof) *

5. Transfer / Character Certificate (T.C.)

6. Caste Certificate (SC/ST/OBC)

7. Residence Certificate (Niwas)

8. Bank Passbook Copy (Front Page)

9. Migration / Gap / Other Docs

9 Declaration & Undertaking (घोषणा पत्र)

Accept Declaration: I hereby declare that all information furnished in this admission application is true, complete, and accurate to the best of my knowledge. I promise to abide by all rules, attendance requirements (min 80%), workshop safety standards, and code of conduct of Shaildevi Private ITI. I understand that false statements will lead to cancellation of my admission.

Applicant Digital Signature / Name (आवेदक का नाम) *

Parent / Guardian Signature Name (अभिभावक का नाम) *

Date (दिनांक)

🔒 Office Use Only (कार्यालयीन उपयोग हेतु - Optional Referral / Verification)

Referred By (प्रवेश संदर्भ / मार्गदर्शक)

Referral Mobile (मोबाइल)

Admission Recommendation

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Admission Application Form

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