Apply for Module 2

Application form for joining Module 2 training. Please note that this training is recommended for those, who are possessing permanent driving license for LMV. If you do not possess permanent driving licence please apply for Module 1 training (Click Here)

Application Form:
Please note down the Reference No. in the pdf file after the Application form submission before proceeding for payment.

Adhar No*:

Complete Name (as in Adhar Card)*:

Gender*: MaleFemaleTransgender
Date of Birth*:
Marital Status*:SingleMarriedWidowedDivorced

Permanent Address*:

City*:

PinCode*:

Mobile*:

Email*:

Confirm Email*:

Permanent Licence No*:

Community:

Sub Caste (if any):

Caste Certificate No:

UPLOADS:
Profile Pic*:
(Max file size 2MB- supports file type gif|png|jpg|jpeg only)

Matriculation Certificate*:
(Max file size 2MB- supports file type gif|png|jpg|jpeg|pdf only)

Police Verification:
(Max file size 2MB- supports file type gif|png|jpg|jpeg|pdf only)

LMV Licence*:
(Max file size 2MB- supports file type gif|png|jpg|jpeg|pdf only)

Caste Certificate:
(Max file size 2MB- supports file type gif|png|jpg|jpeg|pdf only)

All the above information mentioned is true and correct.

Nikhil Pramod Chandrikapure

Mamata Bagade