Rajasthan Institute of Local Self Government

Diploma in Fire Technology and Industrial Safety Management Online Admission Form

(Please read carefully and fill out the correct information below to submit your online form)

Course

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Medium

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General Details

First Name

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Last Name

Father's Name

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Mother's Name

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Date Of Birth

Correspondence Address

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Address Line-3

State

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District

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City/ Village

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PinCode

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Permanent Address

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Address Line-2

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Address Line-3

State

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District

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City/ Village

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PinCode

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Physical Standard (Male/Female):

Male

HEIGHT- 165 cms above | WEIGHT- 50 Kgs above

Female

HEIGHT- 160 cms above | WEIGHT- 40 Kgs above

Education Qualification

S.No

Class

Subject

Board/University

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Year

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Secondary

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Sr. Secondary

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(Internet Result Copy)

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Photo & Signature Details

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DECLARATION

I Hereby declare that all Statements made & information given in this application are ture to the best of my knowledge and belief and in the event of any information found false or incorrect, my candidature is liable to be cancelled and shall abide by all the rules & regulations of the college . The institue is free to take any legal action against me.