SKILL DEVLOPMENT DIVISION

Service Partner Form

Step 1
Step 2
Step 3

A. Service Partner Details

Name of Institution^*:	It is required
Name of Director^*:	It is required
Pin Code:	It is required	Name of State:
Name of district^*:	It is required	Mobile No^* :	It is required
Address: (full address of the proposed site)	It is required
Official Contact Details^*:	It is required
Email ID^*:	It is required	Aadhaar No:	It is required

B. Centre Manager Details

Name of Centre Manager ^*:	It is required
Pin Code:	It is required	Name of State ^*:
Name of district:	It is required	Mobile No ^*:	It is required
Address: (full address of the proposed site)	It is required
Official Contact Details:	It is required
Email ID :		Aadhaar No:	It is required

C. Infrastructural details:

If multi-storied building, the floors being proposed for training
Total built-up area (in Sq Ft)	It is required
Total compound area (in Sq Ft)	It is required
Type of Ownership	It is required
If Leased/Rented, Lease or rent tenure left::	It is required

Approach Road	It is required
Front View	It is required
Back View	It is required
Reception Area	It is required
Domain Lab	It is required
Classroom	It is required
Washrooms	It is required
IT Lab	It is required

DECLARATION

This to certify that all the above information furnished regarding the Institution/ Collage is Correct and authentic to the best of my knowledge

Date:

(Signature, Head of the Institution)

Place:

(Name with Rubber Stamp):