EMA - Safty Institiute bhubaneswar

EEURO MARITIME ACADEMYTM

Managed By Institution of Technical and Educational Organization [ITEO] Trust. | Regd. under Govt.of Odisha

Approved by Bharat Sevak Samaj ( A National Development Agency promoted by Govt.of India)
A Member of National Safety Council of India, An ISO 9001-2015 Certified Institute.
EMA -SAFETY INSTITUTE BHUBANESWAR | SAFTY COURSE BHUBANESWAR | INDUSTRIAL SAFETY COURSES PROVIDER INSTITUTE | BHUBANESWAR | ODISHA | INDIA

+91 - 909 036 6575

SAFETY INSTITUTE BHUBANESWAR | SAFTY COURSE BHUBANESWAR | INDUSTRIAL SAFETY COURSES PROVIDER INSTITUTE | BHUBANESWAR | ODISHA | INDIA

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Student Details

Complete Name:
Course applied For:
Gender:
Male Female
Date of Birth:
Place of Birth:
Email ID:
Student Country:
Nationality:
Phone Number:
Father's Name:
Mother's Name:
Complete Address:
Next to KIN Relation [ NAME AND ADDRESS DETAIL]:
STANDARD PASSED
PASS IN SUBJECTS
Can You Swim ?
Yes No
RELIGION
LANGUAGE KNOWN
PERSONAL IDENTIFICATION MARK
HEIGHT
EYE SIGHT NORMAL [Y/N]
Yes No
COLOUR BLINDNESS [Y/N]
Yes No
HAIR COLOUR :
VISIBLE DISTIGUSHING MARK :
COLOUR OF EYES :
COMPLEXION :
Declaration: I will be flow the all rules and condition for this training course by EMA. ( course fee once paid will not be refundable or it is under refund policy)

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