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    Gramin E-Mitra (GEM) : Please Affix A Recent Passport Size Photograph of Applicant

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    rinku10431
    This document is an application form for the Gramin e-Mitra (GEM) program. It requests basic personal information such as name, date of birth, address, contact details, educational and professional qualifications, skills, and family business from applicants. Applicants must also pay a 350 rupee application fee and declare that all information provided is accurate.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Gramin E-Mitra (GEM) : Please Affix A Recent Passport Size Photograph of Applicant

    Uploaded by

    rinku10431
    20 views2 pages
    This document is an application form for the Gramin e-Mitra (GEM) program. It requests basic personal information such as name, date of birth, address, contact details, educational and professional qualifications, skills, and family business from applicants. Applicants must also pay a 350 rupee application fee and declare that all information provided is accurate.

    Original Description:

    ...................

    Original Title

    Registration Form

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    © Attribution Non-Commercial (BY-NC)

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    This document is an application form for the Gramin e-Mitra (GEM) program. It requests basic personal information such as name, date of birth, address, contact details, educational and professional qualifications, skills, and family business from applicants. Applicants must also pay a 350 rupee application fee and declare that all information provided is accurate.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    20 views2 pages

    Gramin E-Mitra (GEM) : Please Affix A Recent Passport Size Photograph of Applicant

    Uploaded by

    rinku10431
    This document is an application form for the Gramin e-Mitra (GEM) program. It requests basic personal information such as name, date of birth, address, contact details, educational and professional qualifications, skills, and family business from applicants. Applicants must also pay a 350 rupee application fee and declare that all information provided is accurate.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Application Fee: Rs.

    350/- (DD or Cash)

    Gramin e-Mitra (GEM)


    Application Form Application Number (office use only):

    GEM Location:.. 1. Name: Please affix a Recent Passport Size Photograph of Applicant

    2. Fathers/ Husbands Name:

    3. Date of Birth:

    4. Gender: Male / Female

    5. Nationality:

    6. Applicants Address: House No. Village Tehsil District State Pin Code

    7. Contact Details: Landline No. Mobile No. Fax No. E-mail ID

    8. Educational Qualifications: Sr. No 1. 2. 3. 4. 5. Qualification College/ University Year of Percentage/ Remarks Passing Grade

    9. Professional Qualification:

    10. Skills: 1. 2. 3. 4. 5. 6.

    10. Family Business:

    11. How did you hear about this project?

    Declaration I, Son / Daughter/ Wife of

    Shri_______________________________ hereby declares that above furnished information is correct and authenticated and if found any false statement above said for which purely I will be liable for the same. Date: __/__/____ Place:__________

    Applicants Signature

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