11
National Dairy Development Board
Mansinh Institute of Training
Name of training programme: ____________________________________________________
Duration: _____________________________________________________________________
NOMINATION FORM
NAME OF THE MILK UNION:
NAME OF THE PARTICIPANT:
MR./MRS./MS.
GENDER:
MALE
FEMALE
AGE
DESIGNATION:
QUALIFICATION:
EXPERIENCE
: YEARS
MAIN RESPONSIBILITIES/ DUTIES IN DAIRY PLANT:
1.
2.
3.
CONTACT DETAILS OF THE PARTICIPANT:
EMAIL ID: CONTACT NO.:
AMOUNT PAID:
CHEQUE/DD*/E-BANKING NO.:
DATE OF PAYMENT:
*
Cheque/DD to be drawn in favour of “National Dairy Development Board” payable at Mehsana
Nominations to be addressed & emailed to:
Principal,
Mansinh Institute of Training,
National Dairy Development Board,
Post Box No. 2, Radhanpur Road, Mehsana 384002,
Gujarat, India, Ph: 02762-252589
•
Email:
sssinha@nddb.coopSignature of Managing Director
Seal of the Milk Union