Center Code: __________________________
Center Name: _____________________________
APPLICATION FORM for WAVE Courses
Under Skill Development Program for Youth of Rajasthan (2012-13)
Name of Candidate: .
Mothers Name: .
Gender: Male Female DOB (DD/MM/YYYY): .
Marital Status: Single Married Divorced Widow
Mobile Number: Email ID: .
House No./Street/Area: .... City/Town/Village:
State: Rajasthan District: Tehsil: Pin Code: ..
Category: (Tick on your category and sub-category)
SC: TSP: District: Tehsil: . Non-TSP (MADA or Bikhri)
ST: TSP: District: Tehsil: . Non-TSP (MADA or Bikhri)
OBC: Creamy Layer Non-Creamy Layer
SBC: Creamy Layer Non-Creamy Layer
Caste: Religion: Hindu Muslim Sikh Christian Jain Parsi Others
Qualification Board/University Percentage Passing Month & Year 12th Standard (Mandatory) Diploma (Optional) Degree (Optional)
1) 12th Standard Marksheet
2) 10th Passing Certificate (Age-proof)
3) Caste Certificate (If applicable)
1) I hereby declare that all the information furnished by me in this application form are
true, complete and correct to the best of my knowledge and belief.
2) I have not applied at any other IT Gyan Kendra for training under this scheme.