Course Application Form

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All fields are mandatory

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Application for

First Name

Middle Name

Last Name

Date of Birth

Date of Birth (in words)

Place of Birth

Age

T-Shirt Size

Permanent / Correspondence Address

State

Pin Code

Telephone number (R) with Area Code

Phone

Mobile

Father's Name

Father's Profession

Mother's Name

Mother's Profession

Guardian Details

Guardian's Name

Relation with Student

Guardian's Profession

Mobile No.

Declaration / Parents / Guardian

1. I

willing to admit myself/ my son/my ward/my daughter in Personality Development Course/Summer Military Training Course CHME society at my own risk & I will have no claims on authorities for any compensation in the event of any injury or unusual incident due to any accident during the stay/training/traveling from his date of joining the course.

2. I hereby declare that I have made myself acquainted with the rules & regulations of the personality development course/Summer Military Training Course & I accept & agree to abide by them as long as I / my son / ward / my daughter remain in the course. I shall not hold authorities responsible for the safety of myself/ my son / my ward / my daughter.

3. I / my son / my ward/ my daughter is mentally & physically fit. The Medical Fitness Certificate from a Registered Medical Practitioner is attached herewith.

Upload Files

Signature:

Birth Certificate:

Aadhar Card:

Passport Size Photo

PDC & SMTC Indemnity Bond:- Download

PDC Medical Certificate:- Download

Note:
1. Submit original Medical Certificate & Indemnity Bond at the time of arrival/reporting to course.
2. If any type of wrong information / false information / incorrect information found submitted, then admission of the ward will be cancelled.
3. Your selection for the course letter will be shared on your registered E-mail ID.

Confirmation will be received after Successful submission of this form along with the Course Fees and form verification.