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    PGDGC Application Form - Winter Intake 2023

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    aneeshdash06
    This document is an application form for admission to the Post Graduate Diploma in Guidance and Counselling program offered in the winter intake of 2023. The application requests personal details, academic records, employment details, payment details, and a declaration. Applicants are advised to retain a copy of the completed form and submit the scanned copy along with required documents to the program coordinator by email or in person.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    PGDGC Application Form - Winter Intake 2023

    Uploaded by

    aneeshdash06
    19 views2 pages
    This document is an application form for admission to the Post Graduate Diploma in Guidance and Counselling program offered in the winter intake of 2023. The application requests personal details, academic records, employment details, payment details, and a declaration. Applicants are advised to retain a copy of the completed form and submit the scanned copy along with required documents to the program coordinator by email or in person.

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    Application

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    This document is an application form for admission to the Post Graduate Diploma in Guidance and Counselling program offered in the winter intake of 2023. The application requests personal details, academic records, employment details, payment details, and a declaration. Applicants are advised to retain a copy of the completed form and submit the scanned copy along with required documents to the program coordinator by email or in person.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    19 views2 pages

    PGDGC Application Form - Winter Intake 2023

    Uploaded by

    aneeshdash06
    This document is an application form for admission to the Post Graduate Diploma in Guidance and Counselling program offered in the winter intake of 2023. The application requests personal details, academic records, employment details, payment details, and a declaration. Applicants are advised to retain a copy of the completed form and submit the scanned copy along with required documents to the program coordinator by email or in person.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    For office use

    Form No.:

    Post Graduate Diploma in Guidance and Counselling (PGDGC)–Online Mode


    Application for Admission – Winter Intake 2023
    DO NOT STAPLE
    1. PERSONAL DETAILS (Use Capitals) (as it appears in Official Records)
    Affix your latest
    Name: Mr./Ms./Dr.
    passport size
    Middle Name self attested photograph

    Last Name

    Father's/Husband’s Name:
    Mr./Ms./Dr.

    Residential Address:
    (Use Capitals)

    Pin Code:

    Nearest Landmark (Near/Adj./Opp./Behind):


    (to facilitate easy delivery of study material)

    Tel.(Res.): Mob.:
    (STD code) (Number)

    Date of Birth: D D M M Y Y Y Y Nationality: Gender:


    (Specify Date/Month/Year) Indian Male Others
    Email: Others Female

    2. ACADEMIC RECORD
    Examination Subjects/ Board/ Medium of %age / Year of
    Level Course University Instruction Grade /CGPA Passing

    Sr. Secondary

    Bachelor's Degree

    Master's Degree

    Professional

    Others
    3. EDUCATIONAL INSTITUTION YOU ARE CURRENTLY ATTENDING (If applicable)
    Name of Institution University/ Subjects/ Likely date of completion
    Awarding Body Course of the Program/course

    4. CURRENT EMPLOYMENT DETAILS


    Designation:
    Name of the School:
    Name of the Principal:
    School Address:
    State: Pin:
    Telephone: E-mail: Website:
    Experience with Current Employer: Total Experience:
    5. REMITTANCE DETAILS (for RTGS/NEFT/Money Transfer)
    Account Holder: ICTRC Bank: State Bank of India
    Account Number: 67100993075 Branch : Mayur Vihar (Phase II), New Delhi, India
    IFSC Code: SBIN0007881 Swift Code: SBININBB818

    6. PAYMENT DETAILS
    Date of Fee Transfer: Amount:
    Ref. No./Transaction ID: Bank :
    DECLARATION
    I hereby declare that I have read and understood the conditions of eligibility for the program for which I seek
    admission. I fulfill the minimum eligibility criteria and I have provided necessary information in this regard. In the
    event of any information being found incorrect or misleading, my candidature shall be liable to cancellation by the
    Institute at any time and I shall not be entitled to refund of any fee paid by me to the Institute.

    Place:
    Date: Signature of the Candidate
    Checklist
    1. Attested copies of certificates of educational/professional qualifications
    2. Attested copy of experience certificate in the case of non-employed teachers
    3. Deputation letter in the case of Government deputed candidates
    4. Passport size colored photographs

    The candidates are advised to retain a photocopy of the completed Application Form for their records.

    The scanned copy of duly filled in application form along with testimonials should be sent to ssd@ictrc.org

    The Program Co-ordinator (DLP)


    ICTRC Regional Office
    6A, Block A, Phase II, Near MTNL Telephone Exchange
    Mayur Vihar, Delhi - 110091 India
    Phone: 011-43035840, 43048382; Mobile: 9971226076, 9821166307
    E-mail: ssd@ictrc.org; Website: www.ictrc.org

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