04. Registered Address: 1738664950_IMG-20250203-WA0023.pdf Address Line 1: House no 20, preetilata lane Address Line 2: Sukanta nagar District Jalpaiguri Block Rajganj Municipality/ Panchayat Siliguri municipal corporation Village/ Town Siliguri PIN Code 734006
05. Correspondence Address:Address Line 1 House no 20, preetilata lane Address Line 2 Sukanta nagar District Jalpaiguri Block Rajganj Municipality/ Panchayat Siliguri municipal corporation Village/ Town Siliguri PIN Code 734006
06. Mobile No: 7679629178
07. Alternate Mobile No.: 7679138357
08. Email ID: shiladityakarmakar42@gmail.com
09.
Date of Birth
1989-03-01
Gender
Female
Age
35
10. PAN No.: DTEPS5060J
11. Aadhaar No: 509306198295
12. UDYAM Registration No:
13. Artisan Card No.:
14. Brief Portfolio of the Candidate:
15. Highest Educational Qualification: Diploma in telecommunications engineering
16. Occupation : Jewellery designer
17. Highest Professional Qualifications in the Trades Applied for:
Fashion Jewellary and Costume Jewellery Diploma in jewellery making
18. Recognition/ Empanelment/ Affiliation :
19. Work Order / Completion Certificate of Training Programmes conducted under Govt. Organisations/ reputed Non-Govt. Organisations in last 3 years:
20. Awards / Accolades (If any):
21. Photos of Training Programmes/ Awards Received:
22.
Transaction Details 1738664950_IMG_1425.pdf
Transaction No
540073188305
Date of Transaction
2025-02-03
Amount of Transaction
500
From Bank
Bandhan bank
23. Any other Related Information:
24. DISTRICTS AND TRADES APPLYING FOR EMPANELMENT: Darjeeling (Fashion Jewellary and Costume Jewellery) Jalpaiguri (Fashion Jewellary and Costume Jewellery)
25.
Date: 2025-02-04
Place Siliguri
Signature
Declaration(Individual Trainers)
I hereby declare that –
1. The information furnished above are true to best of my knowledge.
2. I would strictly abide by the Terms & Conditions stated in the “Expression of Interest” and deliver the services as
required with optimum sincerity.
3. I have not been barred/ banned/ restricted from any such services from any Govt. or Non-Govt. Organisations in
the past.
4. I have a clean legal background and no Criminal Case has been filed against me in the Court of Law as per my
knowledge.
5. I am able to serve as a Training Provider for both short and long duration Programmes of the selected trades in
the Urban and Rural Areas of the selected District/s of West Bengal along with all types of Machineries,
Equipments and Training Material support as and when required.
6. I am capable of providing Marketing and Network building Support temporarily for the Target groups of Trainees.
