FORM: XB0026

Application format for applying for the training of New AI Technician.
Apply for (Tick Here):
New trained AIT
Needed Training for being New AIT
Paste your latest
Colour Photographs
here and attest by
CVO /
Veterinary Officer
(your area)
Contact No
FORM: XB0026
Paste your latest
Colour Photographs
here and attest by
Gram Pradhan
(Your villages)
CVO/VO
Gram Phadhan
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0 0 0 0 0 0 0 0 0 0
1. Name of the applicant: ____________________________________________________________
2. Father’s Name ___________________________________________________________________
3. Applicant’s date of birth: ___________________________________________________________
4. Address:
Village:____________________________ PO: ________________________________
Block __________________Tahsil____________________District____________________________
Pin Code________________ MobileNo___________________Landline:________________________
5. Educational Qualification (From 10th onwards)
Qualification/
diploma/ degree
Year of
passing
10th
MM .YYYY
12th
MM. YYYY
Graduation
MM. YYYY
Post Graduation
MM .YYYY
Board/University
% marks
6. Experience as AI Technician in years: _________________________________________________
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Visit: http://www.koshishsevafoundation.org
7. Training Details:
Name of Training
Institute
Duration
Grade
From
To
DD.MM.YYYY
DD.MM.YYYY
8. Full Address of Training
Institute___________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________PIN ________________
9. Contact No of Training Institute: +91 ____________________Mobile +91____________________
7. Average no. of AI per month: _______________________________________________________
8. Details of villages in which AI Technician is presently operating in descending order (higher to
lower)
SN
Name of the
village
1
2
3
4
5
6
7
8
9
10
Name of Gram
Panchayat
SN
Name of the
village
Name of Gram
Panchayat
11
12
13
14
15
16
17
18
19
20
Undertaking: I hereby undertake that the information provided above is correct to the best of my
knowledge.
Date: DD.MM.YYYY
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Signature of Candidate
Visit: http://www.koshishsevafoundation.org
Documents Needed:
Once you have submitted your online/off line application, you have to attach following
documents to support your application:
1. Latest Curriculum Vitae/Bio Data
2. Mark sheet:
10th
11th
12th
others ___________
3. Domicile Certificate
4. Experience Certificate (from latest to previous)
5. NOC (If you are working with NDDB or other breeding organization and needed for
starting new centre only)
6. Two colour photographs
OPTION 1
SEND YOUR HARD COPY WITH ALL DOCUMENTS TO:
KOSHISH SEVA FOUNDATION
MH17 PALLAVPURAM PHASE II ,
MODIPURAM, MEERUT 250110,
UTTAR PRADESH INDIA
PHONE: +91 121 2575335
FAX: +91 121 2575336
OPTION 2
YOU CAN SEND US SCAN COPY TO US: [email protected]
For Office Use only:
Application Status:
Interview Date:
Accepted
Rejected
on Hold
Remark If Any _____________________________________________________________________
__________________________________________________________________________________
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Visit: http://www.koshishsevafoundation.org