7 aes Baits Wey flee fat Hot sailed (6x84 Bw vera EMioRS IRA wT SITET wratary afta wenaere (Hei) FI 5. 771-2574925 thee 0771~2574990 E Mail [email protected] ‘ware—02-11/TV(2)/ LPN/2198 wage, ia 11.09.2013 / [HERR / wag aha 1961 } aerfa Prefer aie Tat wHAgaRy wr carte wheel (cries tee) & wa F oferta fees 2530 /— (ora ct sone ota et che) ofa ae Pear ‘grrar we ye ad at oat & fea ware fan yd act do ania ord ame S wae wah we orafera 4 oftert og wate a fe S seer Phar cree we Wg ar | gothaier ua ‘@raferd 1 A oer Ar 3s ae Geer fran wre 81 _ Vieas Kumar Sahu Of Arun Kumar Sahw, vikas Kumar | Electrical | VilePost- Surdung, Bhilsi-3, Dst- Durg (C.G)) pin- aie 7 Sanu Engineering | 400024 mob-7828698427 Emal- | EE(O&M)Dn. Bhi | [email protected] ‘Ageshiwar Dewangan Clo Rathe Lal, ViFGured, ‘Ageshwar | Electrical | PostDaganiya Block-Guncerdehi Dist-Balod i 2 | Dewangan | Engineering | (CG) 491221 mob-7637708667 Email | FE(O8M|Dn.Ourg See eee ee [email protected] Janek Lal Sahu Cio Prem Lal Sahu, Dev Nagar Jhanak Lal | Electrical | Jamul Bhiai Near Prem Kirana Store _Moo- 7 Sahu Engineering | 9575851730, 9308180362 Ema:| FEIORMOnBhiat [email protected] Gulshan Kumar Dewengen Gio Pltambar | 7 Devangan, Dewangan talor word No-15 Guru 4 | Gulshan Kumar | Electrical | Ghesi Das Nagar Bhilsi Moo- 8120285324 | EE(O&M)Dn.Bhilel Dewangan | Engineering | Spach, Das ae Heder Dewe001@omail com Naresh Kumar Sanu C/o. Ghanshyam Prased Naresh Kumar | Electrical | Sahu, Attpost -Madhi, TehTida. Dist-Reipur : . ‘Sahu Engineering | (CG) 493116 mob- sboeactes7, 9617536812 | EE(O8M)On Raipur Erai- pksahu28@amall com Praveen Kumar Tripathi Clo. Eatekrishna Tripathi, | Praveen kumar | Electrical | Shanti Para Bus Stand Bhiai03, Durg (CC) rane © (“Tripathi | Engineering | 490021 mob- 7803020025. Email | SE(O8M)Dn.Bhia pravecniumertingthi@amailoom aah Naveen Chandra Cio Rem Kiipal Chandra 7 | Ghana | enginsettg | AMPost*Ten- Jajaipur, Dist Janjgi-Chames | EE(O&M|Dn.Shakt | gineering | (0,¢,) 496690 mob-8621849875 eee Hitesh Kumar Suryavanshi Clo Shiv Keilash Hitesh Kumar | Electrical | Suryavanshi, Vil#Post Herdi (Ham) Teh | ge ® | ‘suryavansni | engineering | Nawagar, ‘Distvanjgir Champa (C.G.) mo. | EE(OBNIDA.Champa a 8253082147 Emai-hilesh Sunja03@gmaiicom_| 7 Piiamber Das Mahant Gio Sant Das Mana‘, 9 | Paamber Pas | Flectical | atsPost-Teikol, Teh Kharsia,DistRaigarh (C.G}| EE(ORM)ON Raigarh.t neering | mob.8109828787 Emai-pitammd@emaicom | a Narendra Kumar Clo Kurj Lal, In front of Narendra Blecticel | Ambeckar Awas (Baba Kirera Stores) W.No.-18, 0) kumar Engineering | Shakti Nagar, Durg (C.G) 491001 mob: | FE(O8M)ON.Durg ‘aes 54086 [email protected] Dev Charen Nila C/o vit Lal Nira, Vir DeyCharen | Electrical | Nageridin, Post- Kaitha, “TehJajaipur, Dist. 7 Nira Engineering | Janigi-Champa (C.G,) 495661 mob-26 7805401, FECO&M)ON Shak Emal.cevorarannirala67@amal com Fuleshvar Naku Cio Madhav Rao Naidu, Near Futeshvar Blectical | Shiv temple, Gandhi nagar Bila-3 Dist-Durg (CG) 2 Naidu Engineering | 490021" mob- 27708585223 Emaie | FE(Cs)Dn Bilal ful cugagmal.com zrace | Ganga Kamar Patel Cio Wanohar Patel, VFPO-- Ganga Kumar | _Electncal | Ranpata, Teh-Malkharouca Dist-Janjgl-Champa, a *® Patel Enginooring | (C.G) mob-8349480445 EE(O&MIOn Shak Gangavateli001@resitineilcom fH Puneet Ram Sahu Glo Prem Lal, ViFP.O- PuneatRem | Electncal | Bansakara Teh-Simga _ Dist Balouda i“ Sahu Engineering | Ghatopera (C.G) pin-493101 mod-9669901863 | FELOSM)Dn Bhatapara Email i | Bal Ram Padhi Clo Pratap Chandra Padh | Etectical | Beladula Road Telecom. colony _Dist-Ralgarh 46 | Bal RamPadhi | Ersmeering | (C.G.) pin 496001 mob07828165288 Email | EF(OSM)DnReigarh | [email protected] — EEE ‘Vitendra Kumar Patel Glo Manohar Lal Patel, Vir Virendra kumar | Electical | Chamarwah, P.0- Masanya Tha-Sakt, ; 6 Patel Engineering | Janjgi-Champa pin 498689 mob- 9827505809 | FE(O&M)On Shek ILVPATELE32@GMAILCOM i Tecrea |. Swati Clo M, Dhanraja, Si64 G. No= 247K | mswati | gt Zone-2. Khutsiper Bhilai Pokler House mob- | EE(Cily)Dn Bilal nginecring | giosae4s33 EmaiLmswati@amailcom Trecincal | PrSbha Verma Cio Sant Ram Verma, Gulab Nagar 18 | Prabha verna | ,Uectical | khedamara (Jamul) Post: Dhour DistDurg mob. | EE(City)On.Durg feet fe | Engineering | 7354041744 Zreciical | Dinesh Khunte Cfo Khushi Ram Khun, VieP.O 12 | Dinesh krunie | _ectical | Taparda Teh-Pussore Dist Raigath (C.G_) 496100 | EE(ORM)Dn Raigarh!t ngineeting | mop-0685876044 Emaildneshkhunte@amal. com i Bajrang Kumar Kumbnekar C/o Ramesh Kumar Bajrang Kumar | Electrical | Kumbhaksr, VileP.O.- enter, Teh-Balauca Dist. | 70) “Rtmbnakar’ | Engineering | Janie Champa (C.6.) mob-8753598696 Email | FF(O8M)DaChamps [email protected], ‘Shailendra Kumar Verma Clo Ganga Prasad Shailendra | Electrical | Verma, Lo-25 Padum Nagar, Bhilai-3 Dist. Ourg Sie 21 | KumarVerma | Engineeting | (CG) mob-8630670025 eee ‘Vsalenrads i Hemant Kumar Patel Cio Vest Ram Patel, &- HemantKumar | Electrical | 586 Kailasvinar HT.P.S. Colony Dart Vidyut : a Patel Engineerng | Nagar CSPGCL Korba (Wes) mob-8t09066460 | FE(CAM)On Korba City nioatelE22 ‘kash Kumar Cio ish Kumar, Vil-Parna, PO mar | _lestical | Khursipar Teh-Dongargaor, ‘Dist Rajnandgaon saat 23, | Vikash Kur Epameendal Men peo EE(OBM)Dn.Dongargarh sislovesvikesh@amal com | Purusnottam Kasryap Clo Phul Singh Kashyap, Purushottam | Electical | VilBhedra P.O-Sarwa_Tet-Kasdol Dist 24 | “Kashyap” | Engineering | Belodabazar _pin-403344 mob- 9691438006 | FE(OBM)Dn.Balodabezar | [email protected] Z | ‘omar Sanu Cio Rami Satu, Amaseon (Vidhan eSahy | _estical | Shabhe Red Relpur) Post S17. 25 | DomarSahu | Engineering | Raipur(C.G) 490111 mob7876408665 Ema | FELOBMIDn Retour domarsanu 1908@gralcom ishwar Prasad Clo Alakh Ra, Vik Semiva, Post Electrical | Samoda, Thana-Arang, Dist=aipur (C.G.) 482441 eae 26 | Istwar Prasad | Engineering | mob-7826558404 Emabishwarprasad | FE(O&M)On Raipur | sinta786@amail com eee EE often crafty a erres Premed ef on, wikieror arf # rare, arereret wr err yfetel KL TET TTT oz, wR & ches afgit a duet craters wreral A wen vars fee GAT 03, uRen aR et > caviar wey or wx Aanal, ¥ Fryer ar wg eran Ae WAT 04, WRT & Ses og at Ae get a Peary sneer aor od ew feaw Pefioa oars BY TT EPA |os, Ror raf 4 ofrey ar ord /eraere diverts Tel ORY oy ay Reef A afer /Pyfer eh Aware of or wat 3) afer & cet aries § ag wen/ quent a Reft attg at array afaye ofthat i020 & aed wey ORY ea ehh | 06 um ae an oR we aos wt oe OS aie wR aT Ay aPeT aE OF anray ek @ 1 o7, Wg eT order ond et a far A ca feat S ora Teer fa wa orate A cei woktett dar afrard der ger waRaft 3 wa wane S sige doles og toh aws (Wer), ir ital oul ae seer araferar wager @ oe or Heat after ee] — % * i ‘arte a ep (ASO Blatt s OS SRwetetere (ANT) 0% war fa nat, as sari —-02-4 1MV(2)/LPN/2199 rage, feaie 11.09.2013 : rf Sy cate 1 rarer Prey, ey wer HS eM a), wens ar, era ga he ak 400022 | 2, oriorre Pde (x), Beasral, wage! senna Pee per afta (GANG) BRe eral, SAS, 4, woe one vag yar Serer (far) wx Bfae.raf, wage) 5. ats center ar ware «= (Ax) wxrfafadxat, wage / erry / ga /MortieTia / TTI, 6. eordarert alee. / We) / (TER) ease He eee ee eae STATE / TART 7 wRem vi Gate, aeftem gPeeqe site statin ys teeth Cee Fre re rag BotAPPRENTICES CONTRACT REGISTRATION CARD . [Under s2cton 4 of The Apprentices (amendment) Act, 1964] (Must be sutmittad within one month rom the date of joining along wi 8 copy of final year mark shoot ‘altestad wth seal by employer & effdavit, ft necessan) Tro be filed by BOAT(WR), MUMBA 1 Geant pose (6A) Registration No. ae nee TA Alf fimaly @ Recent o)Gratt(Sanoneh) Ase 68) Passpart Size Photograph Hee and putempiyers tam |. Teomican sarowen Arent (TS) ‘sonature an TE organzstons sea 0 at @}-Teanicanvecstons Arrenice VOC) ‘hey appear party on Registered Under Scion 4 oe photograph & ACRG ‘Apprentices Act, 1 Gender Do net pn step Wale Female REGIONAL CENTRAL APPRENTICESHIP ADVISER BOARD OF APPRENTICESHIP TRAINING (W.R), MUMBAI 7 Name of Apprentice (in Capital letiers as given in examination mark shoot) (LastName) (FirstName) (ito Name) Ta) Ponanant adress | (0) Present Rares {ey Whither boonies fo: Sener ve »o ‘Schedule Caste Ys » O Schedule Tribe ves Ow O other Bockvaraciss Yes [No [] Nomadic Tries ves [] wo (J Minorty Commerty Yes [No Pin Code: Pin Code: Oo qo (Specify minorty Community) Pyscaly Handeappes Yes [NOT] Telephone No WWobie NO 4. Date of ith eal? 2 “TL ] &. Gualfing Examination Tor Py ‘apprenticeship training aoe [Boge Diploma HSC (Voc)] | Universty | D'Setne Branch] declaration of Exam Seat No. ‘Board €.pato of commoncament ot _| Petlod of training Rate of stipend tenn From PELL TEE ‘i 0 7. Name & Atldress of the Employer (Phase quote Phone, Fax No. & E-mell id) Pin Code: _ in Code: ote: 41. This Contract Registration Card must be submitted witn botn pages apaearing back to back and not on separate sheets, 2. Ths Contract Registration Cae sliabe fr rejection in case any informaton in any clause ts not furnished | partly furnished,We. the Employer, Apprentice, (Ine Guardian in the case of Minor Apprenticas) and the Surety heraby dectare that wo have read the contents of This Apprenticeship Contract as por The Apprenticeship Rules, 1862, as emended fram tne to Smo, and agroe to bide by all the provisions mace there under. We also declare tial a Une provisos of The Apprentices Act, 1881, a8 amenged {rom time fo time including those relating fo Registration and Termination of Contract are blading on us, We aso understand that traning under The Apprentices Act do nctquarantse 2 0b withthe employer/BOAT ater te traiing is completed. 4. inthe event of termination of Contract through failure on the part ofthe Employer fo carry out the terms and condtions ofthe Contact, he shall pay to the Apprentice @ compensation of an amourt equivalent to three monlhe of minimum stipend payable under The Apprantoas Act. 2. In the event of termination of Contract through faluro on the part of the Apprentice to cary out terms ofthe contract the Surety a he request ofthe Apprentice hereby quaranteas to tho Employer and the Central Gavermert the payment of such ‘amount as may be determined by the Central Apprenticeship Adviser, towards the cost fr training of te Apprentice, 3, The liability of th Surety shat not at any time exceed en amount equal i three months of minimum stipend payable under The Apprenios Ac Signature of Employer and Signature of Apprentice Signature of Surely ‘Seal of Establishment 9" Guardian (in case of minor) Winass: 1. Witness: 1 Witness: 1 (Nave ) Mame (Name i 2 2 . 2, (Name ) ame ) (Name, j a DECLARATION* / AFFIDAVIT (To bo obtained fom the candidate before joining as en apprentice) H son dager of. aged residing a hore solemnly ffi and state es under 41. That I passed my Degree / Diplora / 1012 Vocational Higher Secondary Cartieate examinaton in (Subject) from Poytechnic/ Cotege / Schoo! at (Pace) ‘The dale of dectaraion of my Final year resuitis 2. That ater passing the above said examination ‘2. I didnot have traning or jb experience for one year or mor. | did not undergo apprenticeship training at any place under The Apprentices Act. Whats stated above is ru tothe best of my Knowledge and belie, Date: Paco: SIGNATURE Note ‘The above declaration has to be signed by the cancidala, ifthe gap between date of passing and date of joining the ‘apprenticeship training is less than one year if the gap is move than one year, the affdavithas tobe furnished on a samp paper inthe above format, duly signed by Magistrate Notary. ——S eee CHECK LIST FOR EMPLOYERS Apprertoos Contact Region Cars (ACRC) ie ine "Cou Aa inte prescribed prforma is ones i hare is & oO oO. oto as presoted by BOAT (WR), Mamba, aap of mors than one year batveon the dale of joing ae an ‘pprentce zn dato of dolrtion of eat Photograph o he sperertice bere sigue of emptor wit seal of [—] The photos ot mak host f Vil Samestr of Erag. ‘stabstmon, bth partly appasrng onthe ConvatRogleaten egies couse / Vi Semester of Diploma Coutse ets ty the Cate ae wen fcr of the ealabishient is enciosed (Copy of marshoat ovioaded tom intel ict aerate), enon of 80ST 080 /Ninoiy PH / Woman's made The aprence nas passed al the prevcue eemesrs of the oO forte ppreice Engg Dears /Opioma course [2 Erotoyers 0a! atx onthe Contract Ragin Cad (a egReis soos the Este, Arent, Sty and rinses.