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1 Name in Full (as in SSLC / Matriculation / +2 Certificate )    
2 Date of Birth (Enclose copy of School Certificate )    
  Registration number of school certificate  
3 Nativity  
4 Physical Standards    
  Vision   Normal Glasses
  Blood Group ( Enclose Medical Certificate)  
  Details of any Major illness  
5 Family Details    
  Name Relationship Occupation
6 Permanent Address with Phone no  
7 Details of Academic Record of the applicant in the qualifying Exam.(Enclose Photocopy of the sertificate)
Name of the School / Institute Qualifying Exam Date of Passing / Appearing Total Marks Obtained Percentage of Marks / Class / Division Obtained
8 Technical Training undergone, if any    
9 Sports / Extra Curricular Activities      
  Sports / Activities Level of Participation / Position held Major Achievement Year
      Add More Details  
10 Ration Card number    
11 Parent's / Guardian      
  Annual income    
  Educational Qualification    
  Property Owned (Immovable / Movable)    
12 Declaration by the Applicant      

If selected, I promise to abide by the rules and regulations of the institute, I certify that the information furnished in the application is correct to the best of my knowledge. At any stage if any of the information furnished by me is found to be false, suitable action may be taken against me. I have read the complete prospectus including the Disclaimerchapter and have understood the contents fully. I further fully indemnify the management / Trustees / Shipyards against any and all claims arising out of my syudies in the institute and training at the workshop / shipyard(s). Though the prospectus is in English, I have obtained necessary translation for my full understanding in my mother tongue.

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