Invite Application for Education Counselors, State Coordinators, National Coordinator, Industrial Collaboration/Training

Application Form for Education Counselors/State/National Coordinators

1. Name and Address of the Applicant :

* Name :

* Email :

* Address :

Pin Code :

STD Code :

* Phone/ Mobile Number :

Fax Number :

* Interested in :

2. Programmes (Courses) :

Tentative seats to be filled initially :

3. Address of the Off Campus :

4. Land Detail - Area ( Whether owned or on lease by the applicant )

Acres

Hectares

5. Building: - Details of availability of Built up space (in sqm)

S. No.	Particulars of Built-up Space at proposed permanent site	Area (in Sq. Ft.)
1	Total Instructional Area
2	Total Administrative Area
3	Total Workshop and Lab Area (If applicable)
Total Area (in Sqm)

6. Your Vision (in 50 words) :
7. Your Mission (in 100 words) :
8. Your skills to manage the Faculty :
9. Educational Facilities available with you :
10. Any Other Information :

Security Code

DECLARATION

I, hereby undertake to comply with the Norms and Standards and Regulations of University. I do undertake to furnish the documents as and when required by the University. I agree to fulfill all the conditions as may be stipulated by University form time to time.

I hereby confirm that all the information furnished in the application is true to the best of my knowledge and belief and if any information is found to be false, my application may be rejected.

I Agree