Application Form – Free Silai Machine Yojna

Email:
contactus@gmbvsstrust.org

APPLICATION FORM FOR FREE SUPPLY OF SEWING MACHINES

Gramin Mahila Aaur Bal Vikash Sewa Sangh Trust

Mob:
+91 8235881010

1. Name of the Applicant *

2. Male / Female *

Female Male

3. Mobile Number *

4. Email *

5. Date of birth & Age (20-40 Yrs) *

Date of Birth

Age

Passport size
photo enclosed
(3.5cm x 4.5cm)

(Max 30KB Image)
(Click to Upload)

DETAILED INFORMATION

6. Address *

7. Caste / Community *

8. Annual Income *

Should be below Rs. 1,20,000/- as per certificate.

9. Under what reason the Sewing Machine requested? *

Poor Destitute widow Deserted wife Handicapped

10. Is sewing machine was received previously? *

Yes No

11. From whom the stitching was trained? *

CERTIFICATES TO BE ENCLOSED (FILE UPLOADS)

1. Income Certificate (Below Rs.1,20,000/-)

Choose PDF File...

2. Proof for Age (20 to 40 years)

Choose PDF File...

3. Community Certificate

Choose PDF File...

4. Proof for knowing Tailoring

Choose PDF File...

5. Special Certificate (Handicapped/Widow/Deserted)

*If applicable based on reason

Choose PDF File...

Declaration: I hereby declare that all the information submitted by me in the application form is correct, true and valid. The enclosed certificates are genuine. I understand that if any information is found false, my application will be rejected.

Signature
(Max 20KB) • (Click to Upload)

Signature of Applicant