Govt. of
Community Information Centre
Under the Ministry
of Information Technology, Govt. of
Ministry of
Industries & Commerce, Govt. of
Passport size photo For office use Std. id.: Batch : Timing : Date of adm:
National Informatics Centre
North
lakhimpur
Application form
1. Name:
_________________________________________________________
(Capital letters)
2. Father’s name: ___________________________________________________
3. Courses Applied for: 3 months Website designing&Internet.
6 months 15 days
1 year 1 month
4. Date of Birth : ________________________________________________________
5. Address : ________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
6.
Qualification : HS PG DEGREE Others
Specializations : ________________________________________________________
7.
Whether you have taken Maths as a
subject in H.S. Yes No
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For
office use Std. id.: Batch : Timing : Date of adm:
It is declared that Mr/ Mrs/Miss ___________________________________ has been admitted as a trainee in CIC, Lakhimpur Development Block, Lakhimpur.
Our Address: Konwar Gaon, Lakhimpur Phone : 242458(o) Email : asm-lakhimpur@cic.nic.in Web site : http://ruralserver.nic.in/
icenrich/lakhimpur.asp
Course Coordinator
CIC, Lakhimpur