MSSU

* Fields are Mandatory

* Surname :

*First Name :

Middle Name :

*Full Address for Communication :

* City :

*Taluka :

* District :

*Pincode :

* State :

*Gender :

* Email ID :

* Enter valid Email ID

Alternate Email ID :

* Date of Birth :(DD/MM/YYYY) :

*Mobile Number :

* Religion :

*Domicile State :

* Category :

* Blood Group :

* ITI Trade Name :

* ITI Trade (In Years) :

* ITI Institute Name :

* Work Exp (In Years) :

* Apprenticeship (In Years) :

* Course Interested In :

Education Qualification (Fill as relevant) :

S No.	Institute Name	University/Board	Year of Passing	Percentage
1

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*I declare that the information provided above is true, complete and correct.