Central Food Technological Research Institute
INTERNATIONAL SCHOOL OF MILLING TECHNOLOGY
MYSORE – 570 020
Telephone: +91-821-2343982, Fax : +91-821-2517233,
E-mail : /
Application for admission to the REGULAR COURSE in
FLOUR MILLING TECHNOLOGY(Academic year: 2018-2019)
1. Name:
(Full and in Block Letters) / Please affix your recent colour passport size photograph
2. Mailing Address:
(In Block letters)
Pin Code:…………………
Phone: / Email:
3. Gender: Write 1-Male, 2-Female & 3-Transgender / Nationality:
Day Month Year Years
4. Date of Birth: Age: / SC/ST/OBC/GEN
5. Category:
Note: Attach attested copy of certificate issued by the competent authority (For SC/STOBC)
6. Educational Qualification:
Name of the Degree / Diploma / University / Institution / Aggregate % / Division / Year of passing
Note: OGPA / CGPA to be indicatedequivalent in percentage (%)
7. Details of NEFT (National Electronic Fund Transfer) : Application Fee: Rs.______
UTR No.( Unique Transaction Reference Number):
Bank Name & Branch______
Note: a) Fill the application by typing/legible and neat handwriting
b)INCOMPLETE APPLICATION WILL NOT BE CONSIDERED FOR ADMISSION
c)Any change of address as given in col. 2 should at once be communicated to The Coordinator, International School of Milling Technology, CFTRI, MYSORE-570 020, INDIA
* Score off inapplicable terms in the application
8. Passport details* (Applicable to Foreign Nationals)
Pass port Number: Valid up to:
Date and Place of issue:
9. Knowledge in English: Read Write Speak
Tick (√) appropriate box
10. i. Is any member in your family a Miller / Mill Owner? YES / NO
ii. If yes, please give his / her address and relationship to you
11. Record of Academic/Technical Training:
(Particulars of examination passed starting from SSLC or equivalent Examination or other Long and Short term training courses*)
Exam Passed / Name of School/College/ University / Principle Subjects / Year of Passing / % of marks / Remarks
SSLC/ SSC or equivalent
Higher sec./ Pre-university
Degree/ Diploma
Any other specify
12. Scholarships / Awards / Prizes etc, if received
*Provide conversion formula for % in case of OGPA/CGPA along with your marks sheet/ grade card
*Please enclose attested true copies / photocopies of marks sheets / grade cards/ certificate of all examinations passed
13. Employment Record / Professional Experience
Name and address of the Company / Employer / Nature of Business/ Product / Period Employed / Designation & Responsibilities
From / To
Please enclose proof of your employment experience
14. i. Company / Mill sponsored: YES / NO
(If yes, please enclose a certificate to the effect that your company/
Mill bears entire expenditure of your training covering tuition fee,
industry visits, boarding and lodging etc., for entire period)
ii. Director / Partner of the above company / Mill/ YES / NO
sponsoring your candidature:
iii. Name and address of the sponsor:
iv. Mill details ownedby the sponsor: Name :
Address :
Capacity : Tons/day
15. Reference:
Give two prominent references (other than relatives) of persons who have known you well personally and professionally
Name and Position / Business Address / Period for which he/she knows you / Capacity in which he/she knows you
1.
2.
16. Any other information:
17. List of enclosures:
- Application form along with Bank NEFT details
- v.
- vi.
- Vii.
DECLARATION
I declare that the above information furnished by me is true to the best of my knowledge and belief. If selected, I hereby agree to abide by the Rules and Regulation in force from time to time at the International School of Milling Technology, Central Food Technological Research Institute.
Countersigned Signature of Candidate **
Signature of Parent/Sponsorer
Date:
Place:
**Please enter Bank NEFT details for Rs. 500/-(Indian participant) or details of International Money Order or Wire transfer for US$ 50 (Foreign participant)
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