KRISHI VIGYAN KENDRA, BARAMATI

                              AGRI-CLINIC AND AGRIBUSINESS                                     Paste here

                                                           CENTERS CELL                                                your recent

                                                                                                                               photograph

               

 

 Name

 

 Surname first

 

 I D Number

 

            Date of Birth   

 

(To be filled by center)

      
 

Address for        Correspondence

  
 

 Permanent

Address

 
     
 Telephone No.   Res.   Office Mobile
   
e - Mail  
   

Educational

Qualifications

Exam. Passed

College / University Year Of Passing Marks obtained %
       
       
 

 

Your present situation 
 Entrepreneur  Employee- Given Details Fresh Graduate Other -Gives Details

 
Category
SC       ST      OBC        DTNT      OPEN OTHERS GIVE  DETAILS
Agri. Enterprise of your interest   Venue of your Agri. Enterprise Detail Address
Have you Submitted A Project To Any Bank ?

 

   

Place   :

Date    :                                                                                                                                       Signature

 

 

 

                Krishi Vigyan Kendra, Baramati

    Agri-Clinics and agribusiness center cell

_______________________________________________________

                                             

                                                          undertaking by the candidate

I the under signed Mr./Mrs.                        

Tal.                                    Dist.                                             declare that before this I have not

availed the training under  agri. - Clinics and Agribusiness centers scheme from any institute

located within or outside the state

Place   :-

Date   :-

                 Signature