FOR PARTICIPATION IN SHORT-TERM COURSE
Course Title
Venue
The Chosen Batch with Dates
1.
Name of the Applicant
(in full, in BLOCK letters)
Mr./Mrs./Ms.
2.
Address
Telegraph Address
Telephone No.
Fax No.
E-mail
3.
Date of Birth
4.
Qulifications (Starting from Graduation)
Degree
University
Year
(1) Academic
(2) Professional
(3) Computer Courses Attended
5.
Sponsoring Organisation, if any,
Organisation Address
6.
Details of Present Post
Designation
Period of Service
7.
Whether Accomodation facility needed
Yes
No
8.
D.D.No.
Date
Amount
(DD should be drawn in favour of Director, INSDOC, New Delhi)
or
(Scientist-in-Charge, INSDOC Regional Centre, Chennai for courses conducted by RCM, Chennai)
Date:
Place:
Candidates's Signature
