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 b IQS/FR/05  (FORM TO BE FILLED IN CAPITAL LETTERS ) ENROLLMENT FORM Course Name : _________ dated from _________to Candidate’s Name : __ (LAST NAME) (FIRST NAME) (MIDDLE NAME) Is your course Company Sponsored or Self Sponsored? __________________________________ If Company Sponsored, please fill up below information: Company Name : ______________________________________ Company Address : _____________________  _________ ________ ________ Company E-Mail : _______________________________________ Person to whom invoice should be addressed : _________________________________________ Personal Address : ______________________________________  _______ _________ Personal E-Mail : _____________________________________________________________ Required Name as on Certificate 1) Self Name : Mr/Ms/Mrs/Smt___________________________________________________________________ 2) Company :  _________ __________ (Off) Tel.___________ Fax No. ___________ (Resi)Tel. ___________(Mobile)_________________ A. Educational Qualification  : __ ____________ (Attach copy of necessary certificates) B. Experience : (In the NDT Technique applied for.) (Attach document from employer as per eligibility requirements.) C. Payment Details  : _____________________________________________________________ Cheque / Demand Draft No: ______________________dt______________________________ Signature of Candidate Seal & Signature of Employer Note :  The Payment shall be made by Cheque (for Pune)/ DD (for outside Pune) payable to ‘ Insight Quality Services ’. Outstation cheques should include Rs.100/- as additional clearing charges.   Please send Qualification, Experience Certificates and two passport size photographs along with Enrollment Form.  The Eye Test will be conducted on the first day of the course. Only those candidates meeting the requirements can appear f or certification exam. Please use Photo Copy of this form for more nominations. [ IQS/ FR-05 01  Candidate Code - Invoice Number :

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  • b

    IQS/FR/05

    (FORM TO BE FILLED IN CAPITAL LETTERS) ENROLLMENT FORM

    Course Name : _____________________________ dated from _________to ____________

    Candidates Name : ______________________________________________________________ (LAST NAME) (FIRST NAME) (MIDDLE NAME) Is your course Company Sponsored or Self Sponsored? __________________________________

    If Company Sponsored, please fill up below information: Company Name : ______________________________________________________________

    Company Address : ______________________________________________________________

    ______________________________________________________________

    Company E-Mail : ______________________________________________________________

    Person to whom invoice should be addressed : _________________________________________

    Personal Address : ______________________________________________________________

    ______________________________________________________________

    Personal E-Mail : ______________________________________________________________

    Required Name as on Certificate 1) Self Name : Mr/Ms/Mrs/Smt___________________________________________________________________

    2) Company :____________________________________________________________________

    (Off) Tel.___________ Fax No. ___________ (Resi)Tel. ___________(Mobile)_________________

    A. Educational Qualification : _____________________________________________________ (Attach copy of necessary certificates)

    B. Experience : _________________________________________________________________ (In the NDT Technique applied for.) (Attach document from employer as per eligibility requirements.)

    C. Payment Details : _____________________________________________________________ Cheque / Demand Draft No: ______________________dt______________________________

    Signature of Candidate Seal & Signature of Employer

    Note : The Payment shall be made by Cheque (for Pune)/ DD (for outside Pune) payable to Insight

    Quality Services. Outstation cheques should include Rs.100/- as additional clearing charges. Please send Qualification, Experience Certificates and two passport size photographs along

    with Enrollment Form. The Eye Test will be conducted on the first day of the course. Only those candidates

    meeting the requirements can appear for certification exam.

    Please use Photo Copy of this form for more nominations.[ IQS/FR-05(01)

    Candidate Code - ________

    Invoice Number :


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