THROUGH HUMANITY TO PEACE
Indian Red Cross Society
&
St.John Ambulance (India)
HARYANA STATE BRANCH
Home
Registration Form For Industry
Industry Infromation
Name of Industry (As display on the PAN Card)
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:
*
PAN Card Number
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:
Invalid PanCard
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Do you have GSTIN No.
*
:
Yes
No
Enter GSTIN Number
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:
Invalid GSTIN Number
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Industry Address
Address/Locality
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:
*
City/Town/Village :
Tehsil/Post Office :
District
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:
--Select--
Ambala
Bhiwani
Charkhi Dadri
Faridabad
Fatehabad
Gurugram
Hisar
Jhajjar
Jind
Kaithal
Karnal
Kurukshetra
Mohindergarh
Nuh Mewat
Palwal
Panchkula
Panipat
Rewari
Rohtak
Sirsa
Sonepat
Yamuna Nagar
Chandigarh
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State
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:
Haryana
PinCode
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:
*
Contact Person Details
Training Coordinator
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Designation
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*
Mobile No.
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10 digit Only
Email ID
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:
*
Invalid Email
Number of Employees
First Aid Professional training to 30% of the total employees (including Regular, Contractual, Out Source, Daily Wages or by any other mode
for Both Security Guards and other Employees) for every Industry and 100% Security Guards has been mandatory in the State of Haryana
Valid Certificate : Date of issue should not be more than 3 years old
* All fields of this section are mandatory
Regular
Contractual
Out Source
Daily Wages
Total
No. of Employees Already
Trained with valid Certificate
Employees
(other
than Security Guard)
Security Guards
Choose Password
Password must be between 8 to 20 character length, must contain at
least one number, one uppercase letter and one lowercase letter.
Password
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:
*
Confirm Password
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:
*
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Security Code
Enter Security Code
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:
*
I hereby declare that the information given in this application is true and correct to the best of my knowledge