Anitech

* Institute Location

State

District

City / Town / Village

* Institute Information

Name of the Institute P.O.

Year of Establishment P.S.

Status of The Institution PIN

* Institute Contact No.

Phone1

Phone2

Email Address

* Information About Center Head

Name of the Center Head District

P.O.

State P.S.

Mobile Nationality Marital Status Center Director OR Center's Pan No.

Email Address of the Center Head Religion Educational Qualification of the Center Head

Sex

* Available Infrastructure Facility of the Center

Office Room Staff Room

Practical Room Reception

* Faculty Information of the Center

(As on date of proposal)

Name

Qualification

Teaching Experience

Status Full time / Part time

* Details of Available Facilities of the Center

No. of Computer Internet Facility

Inverter / Generator Facility

Licensed Software No. of Projector / LED

* Upload Documents

Colour Passport Size Photograph of The Head of The Institute Voter Card of The Institute Head (Both Side in One Page) Trade License / Registration Certificate of The Institute

Declaration

I hereby certify that the context stated above are correct and true to my knowledge and belief and hereby confirm that our Organization / Society / Trust is free from any legal / official disputes whatsover.I accept that any facts stated above. I found incorrect will automatically result in cancellation for nominations associate.However I will have no right whatsover to fight / challenge legally against the judgment in any court of law. All disputes are subject to Jhargram Jurisdiction only.

Application Form For Affiliation

Study Center Applied For