Dinesh Chandra Gupta

Colour Academy KYC form Division _________________ Region_________________ Area_________________ Territory_________________ Venue_________________ Personal Details First Name _________________ Middle Name _________________ Last Name _________________ Gender Male / Female / Others Address _____________________________________________________________________________________ Mobile Number 1 _________________ Mobile Number 2 _________________ Participant BP Number _________________ Contractor BP number_________________ Dealer Name_________________ Contractor Name _________________ Contractor Number_________________ Training Program Name _________________ From Date _________________ To Date _________________ Type of ID Proof & Mention the ID proof Number Pan Card Passport Voter ID Driving License Aadhar Card Others _________ Type of Address Proof & Mention the ID proof Number Driving License Passport Voter ID Electricity Bill Aadhar Card Others _________ I hereby declare that the information declared in this form is true and correct and that I am a resident Indian. I have attended the training mentioned in this form. Name and Signature of the Participant Name and Signature of the Trainer Enrollment Form (Pre KYC) (To be filled in all training programs by the participant) Questions Options To be filled by the Participant Type of Participant Helper | Painter | Contractor | Others ______ Course Fees paid through Cash | Free coupon | Discount. Fees in Rs _________ Anyone Sponsoring for the course fees Self | Contractor | CA | Others ______ How did he come to know about the CA? Internet | Dealer | Contractor |Painter | NGO | Others _________ Nominated by Self | Contractor | Dealer | Others __________ Prior experience Nil | 1-2 years | 2 or more years During the training days, any loss in income / salary? Yes | No Loss of Salary during training compensated? by AP | Contractor | Not compensated? For all courses (Except BPC)- How many sites using this Specific Course undertaken by you, do in a month? Nil|1-2 sites|3-4 sites|5 sites or more For BPC - How many sites in you do overall in a month? Nil|1-2 sites|3-4 sites|5 sites or more Post Training Feedback (To be filled in all training programs by the participant) Feedback Questions Options To be filled by the Participant Q1. Was the course content easy to understand? Very Easy | Easy | Difficult | Not Understood Q2. How did the program pace suit you? (Duration of course) Very Comfortable | Comfortable | Not Comfortable Q3. How was the overall engagement of participants during the training? Very Good | Good | Average Q4. Presentation or explanation Skill of trainer? Very Good | Good | Average Q5. Response to participants queries? Very Good | Good | Average Q6. Did the training start and finish on time by trainer? Yes | No Q7. How was the overall atmosphere | layout of Colour Academy? Very Good | Good | Average Q8. How was the cleanliness at Colour Academy? Clean | Average | Unclean Q9. Will you recommend the course to others Yes | No Any other comments