Application Form for Orientation/ Refresher/ STC

Select Course
First Name:*
स्वतःचे नाव
Middle Name:*
वडिलांचे नाव
Last Name:*
आडनाव
Date of Birth: *
जन्मदिनांक
Gender: *
लिंग
Designation:
Faculty:
Subject:
PG Qualification:
PG Passing Year: *
Other Qualification: *:
NET
SET
M.Phil
Ph.D.
None
MPhil Passing Year: *
NET/SET Passing Year: *
Ph.D. Passing Year: *
Nature of Appointment:
Name of College/ University:*
Taluka/ Tahsil:*
District:*
Pincode:*
State:
Affiliating University:
Whether your institute has 2(f) 12(b):
Communication Address
Correspondence Address *:
District * (please type if not in the list):
Taluka *(please type if not in the list) :
Pincode:*
State: *
राज्य :
Mobile Number *:
Alternate Contact Number:
Email: *
ईमेल:
Date of Appointment in Senior College: *
Category:
Whether Attended RC/ OC (OP):
Details of Orientation Programme attended earlier
Attendend Month & Year (DD-MM-YYYY):
Name of Orientation Programme:
Name of HRDC/ ASC where attended:
Details of Refresher Course Attended earlier
No. of RC Attended:
RC Month & Year:(DD-MM-YYYY)
Name of Refresher Course:
Name of HRDC/ ASC where attended:
First Placement Details
AGP:
Due Date of Placement: *
Second Placement Details
AGP:
Due Date of Placement: *
Third Placement Details
AGP:
Due Date of Placement: *
Application Processing fees (Non Refundable) details
DD shall be in favour of "Director, UGC-HRDC, Dr. BAMU, Aurangabad"
DD No. :
Bank Name. :
DD Amount. :
DD Date: *
Security Code : *
सुरक्षा संकेतांक :