WEST BENGAL MINORITIES’ DEVELOPMENT AND FINANCE CORPORATION
APPLICATION FORM FOR ADMISSION TO DIPLOMA IN GRAPHIC DESIGN
Personal Details
Applicant's Name
*
:
Father's Name / Husband's Name
*
:
Gender
*
:
Select Gender
Male
Female
Other
Religion
*
:
Select Religion
Muslim
Christian
Sikh
Parsi
Jain
Buddhist
Marital Status
:
Select Marital Status
Married
Unmarried
Others
EPIC No.
:
Aadhaar No.
*
:
Address Details
Present Address
District
*
Select District
ALIPURDUAR
BANKURA
BIRBHUM
COOCHBIHAR
DAKSHIN DINAJPUR
DARJEELING
HOOGHLY
HOWRAH
JALPAIGURI
JHARGRAM
KALIMPONG
KOLKATA
MALDAH
MURSHIDABAD
NADIA
NORTH 24 PARGANAS
PASCHIM BARDHAMAN
PASCHIM MEDINIPUR
PURBA BARDHAMAN
PURBA MEDINIPUR
PURULIA
SOUTH 24 PARGANAS
UTTAR DINAJPUR
Sub Divisional Office
*
Select Sub Divisional Office
Block / Municipality Type
*
Block
Municipality ( Corporation )
Block / Municipality
*
Select Block/Municipality
Police Station
*
Post Office
*
Ward No /GP Name
*
Address
*
:
Pincode
*
Permanant Address
Same As Above
*
District
*
Select District
ALIPURDUAR
BANKURA
BIRBHUM
COOCHBIHAR
DAKSHIN DINAJPUR
DARJEELING
HOOGHLY
HOWRAH
JALPAIGURI
JHARGRAM
KALIMPONG
KOLKATA
MALDAH
MURSHIDABAD
NADIA
NORTH 24 PARGANAS
PASCHIM BARDHAMAN
PASCHIM MEDINIPUR
PURBA BARDHAMAN
PURBA MEDINIPUR
PURULIA
SOUTH 24 PARGANAS
UTTAR DINAJPUR
Sub Divisional Office
*
Select Sub Divisional Office
Block / Municipality Type
*
Block
Municipality
Block / Municipality
*
Select Block/Municipality
Police Station
*
Post Office
*
Ward No/GP Name
*
Address
*
:
Pincode
*
Contact Details
Email Address
:
Mobile No
*
:
WhatsApp No.
*
:
File Attachment
EPIC/ Voter card frontpage
*
:
Max file size is 2 MB (jpg , jpeg , png)
Highest Qualification Certificate
:
Max file size is 2 MB (jpg , jpeg , png)
Aadhar Card Frontpage
*
:
Max file size is 2 MB (jpg , jpeg , png)
Adhar card Backpage
:
Max file size is 2 MB (jpg , jpeg , png)
EPIC/Voter card Backpage
:
Max file size is 2 MB (jpg , jpeg , png)
Upload Photo
*
:
Max file size is 2 MB (jpg , jpeg , png)
Other Details
Whether suffering from any chronic disease, if yes please specify
*
:
Qualification Details
Sl. No.
Exam passed
Name of Board/ University
Stream/Subjects
Year of passing
Marks obtained (in %)
1
Madhyamik or its equivalent
2
Class XII/HS
3
Graduation
4
Post Graduation
Submit