Application for Admission to Distance Education Programmes 2019
Application No
Application Date
Course Name
Name of the Student (same as in the SSC/Maticulation Certificate) in Capital Letters
Father's Name
Mother's Name
Permanent Address
Address for Correspondance
Phone / mobile No
Email ID
Date of Birth
Gender
Select
Male
Female
Others
Nationality (Indian / Foreign)
If Foreign national, name of the country
Particulars of Past academic record (from Bachelor's Degree onwards)
Sr.#
Examination
University / College
Month & Year of Passing
Subjects Studied & Passed
Maximum Marks
Marks Obtained
Percentage
Division
1
Delete
Previous and present professional experience if any
Sr.#
Designation and nature and job done
Organization / Institution Total No. of years worked
From(month & year)
From(month & year)
1
Delete