Application Form - Mar 11-20

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SP/FRM/AP/105

Rev.01
Effective Date : 01.01.14

TATA STEEL ADVENTURE FOUNDATION


ADVENTURE PROGRAMMES
JRD Tata Sports Complex (Eastern Wing), Jamshedpur-831001
Phones : 0657-66-45189/43389 P&T: 0657-2756575

(HIMALAYA APPLICATION FORM)


(Filled in Application Form to be submitted to Adv. Prog. Dept)

Through Controlling Officer ......................................................................


Programme : Outdoor Leadership Course

From : 11-03-15 To: 20-03-15

1. Full Name in Block Letters

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

2. Fathers / Husband Name

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

3. Mothers Name

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

4. Sex

MALE FEMALE

Date of Birth: .....

5. Occupation & Organisation

6. Employee Id No.

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

7. Office Address & Phone No.

.....

8. Undertaking

I agree to be disciplined during the programme & Obey the


staff of TSAF, failing which I will not hold the TSAF or its
Staff wholly or partially responsible, in case of an accident
or injury during the programme.

9. New Entrant

10. First Time Entrant

Have you participated in the programme before.


YES
Have you participated in any other
Programme of TSAF.
YES

11. Outbound Training Programme :

NO
NO

I have fully understood the meaning and significance


of the Outbound Nature of the training programme.

Residential Address :
..

Signature...

..

Name.

Contact No. ..

Date ...

Email Id. .....

Place

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