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Form PGDC 3rdb

This document is an application form for admission to a 26-week postgraduate diploma course in transmission and distribution systems. It requests information such as the applicant's name, address, date of birth, educational qualifications, work experience, proof of identity, and whether accommodation is required. The applicant must also provide details of a demand draft for the application fee and sign and date the form.

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Atul Chauhan
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© Attribution Non-Commercial (BY-NC)
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77 views2 pages

Form PGDC 3rdb

This document is an application form for admission to a 26-week postgraduate diploma course in transmission and distribution systems. It requests information such as the applicant's name, address, date of birth, educational qualifications, work experience, proof of identity, and whether accommodation is required. The applicant must also provide details of a demand draft for the application fee and sign and date the form.

Uploaded by

Atul Chauhan
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Central Board of Irrigation & Power

Malcha Marg, Chanakyapuri, New Delhi 110021 Phone: 011-26115984, 26876229, 26116567, 24102437 Fax: 011-26116347 E-mail: [email protected] Web: www.cbip.org
NEW DELHI

Affix One Photograph (Self attested)

ISO 9001:2008

Attach one more self attested photograph

Application Form for Admission in 26 Weeks Post Graduate Diploma Course in T&D System (3rd Batch)
1. 2. Name of the candidate (in full) In capital letters Mothers Name With occupation & official address, (if any) with Phone No. & Email ID Fathers Name, With occupation & official address, with Phone No. & Email ID Date of Birth (age on 9-4-2012 in years ) Sex (mark 3) Blood Group Marital Status (mark 3) Nationality Postal address Email address Phone No. Land Line: Mobile: 12. Educational Qualifications University/ Board Year of passing % of marks* Subjects/Branch Single Married DD MM YYYY Years

3.

4.

5. 6 7. 8. 9 10. 11.

Male

Female

Exam. Passed 10th or equivalent 12th or equivalent Diploma B. Tech. or equivalent Others

* In case of candidates having CGPA/CPI system of marks, they may write the marks as per the conversion
chart of their University.

13.

Whether the Candidate had CGPA/CPI marking system during his/her B.Tech degree Experience (if any) S. No. Orgnisation

Yes

No

14.

Designation

Job profile

Year of Service

15.

Sponsored (mark 3) (if Sponsored, attach certificate from employer on company's letter head as per Sponsorship Format given on website Proof of Identity (Copy to be attached) (mark 3) List of documents (attach self attested photo copies) (Tick mark as applicable)

Yes

No

16. 17.

(Pan Card / I-Card / Driving Licence / Passport) (1) Mark sheet & certificate of Class X (2) Mark sheet & certificate of Class XII/ Diploma (3) Mark sheet & certificate of Engg. Degree (4) CGPA/CPI converssion chart issued by registrar/controller of University (5)

18. 19.

Whether Accomodation in hostel is required (mark 3) Details of Demand Draft (for Application Money)

Yes Amount Rs. Bank name DD No. Date

No

20.

Signature with date.

FOR OFFICE USE ONLY


Enrolment No. Application Fee for Rs. 600/DD No. Bank Type of Candidature Certificate Proof Attached : Sponsored Age Qualification Sponsorship OR Date Branch Code Non-Sponsored Yes Yes Yes No No No NA

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