NIRD&PR

Admissions Into 14th Post Graduate Diploma in Rural Development Management (PGDRDM) August 2017 to July 2018

Application Form


Feilds with marks are mandatory
Application Category :
Surname :
Last Name :
Father's/Guardian's Name :
Mother's Name :
Date of Birth :
Place of Birth :

Postal Address

Correspondence Address

H.No.
Street/Locality :
City :
District :
State :
State Name (For International Condidates only):
Pincode :
Country :
Telephone Number(with STD/ISD code) :
Mobile Phone Number :
E-mail Address :
Check here, if correspondence and permanent addresses are same.

Permanent Address

H.No.
Street/Locality :
City :
District :
State :
State Name (For International Condidates only):
Pincode :
Country :
Residence Telephone No:
Father's/Guardian's Mobile Phone Number :

Personal Details

Blood Group (for preparation of Id card, health insurance papers etc.) :
Sex :
Category :
Caste name,if OBC :
Belongs to PWD
Domicile state :
(North-east students should attach copy of the Permanent Resident Certificate (PRC))(Indian Candidates only)

Academic background

S.NoEducational Qualification *Degree NameSpecialization/SubjectsYear of passingUniversity/Board Name)Class/Division % of marks
1SSC/Class X





2Intermediate/Class XII





3Graduation Degree





4Post-Graduation





5Any other Degree/Diploma





        

Entrance Test Center Preference: (Indian candidates only)

Preference I :
Preference II :

DD Details

DD Number :
Bank Name(with branch):
Date of Issuing :
IFSC Code :

Upload Documents:

Photo(.jpg format) :

Signature(.jpg format) :

Proof of age (S.S.C or equivalent certificate)(.pdf format) :

Degree Marks & Certificate/Provisional (.pdf format):

Copy of DD (.pdf format):

Post-graduation Marks & Certificate/Provisional (.pdf format):

Work experience Certificate for In-service candidates (.pdf format):

Organisational sponsorship letter, if you are an in-service candidate (.pdf format):

SC/ST/OBC (Latest) Certificate (.pdf format):

PWD (Latest) Certificate (.pdf format):

Latest Bonafide Certificate from the institute last studied/served (.pdf format):

Vaccination and medical fitness report from the competent authority for international students (.pdf format):

Permanent Residance Certificate(North-east Candidates only)(.pdf format) :

Declaration by the Applicant

 
I hereby certify that all the information furnished above by me is correct to the best of my knowledge and belief. I understand and accept that furnishing any false information on my part will automatically lead to disqualification of my candidature and forfeiture of all payments made by me to the NIRD&PR. I agree to abide by the code of conduct and rules as may be framed from time to time by the NIRD&PR.
Date : 5/30/2017
Place :