Centralised System
Application Form For Affiliated Partners

Notes :

****Please Fill up all the tabs and then submit
Details of InstitutionDetails of the ManagementFaculty and Staff DetailsLibrary DetailsDetails of Project Co-ordinatorCourse Structure
1.Details of Institution :
Program Applied For :
Name of the Institution :
Name of the Parent Body :
Year of Establishment :
Registration No :
District :
State :
Institute Head Name :
Institute Head Designation :
E-mail ID :
Alternate E-mail :
Proof of Identity(Identitiy Card/Passport) :
Website Address :
Country :
Office Number :
Mobile Number :
2.Are You Associated with any University/Institution for Distance or Regular Education ? If so,give Details.
Sl No.Name of The InstitutionName of the University/InstituteAssociated SinceModeProgrammes Being OfferedNo. of Students
01
02
03
04
05
06
3.About the Proposed Institution :
Regd. Address :
City :
Postal Code :
State :
Country :
Office Number :
Mobile Number :
Correspondence Address :
City :
Postal Code :
State :
Country :
Office Number :
Mobile Number :
4.About Location :
Prime Location :
Is Parking Space Available?
Is Property :
Is Property :
Total Carpet Area(In Sq.ft) :
5.Connectivity :
Nearest Airport Name :
Airport Distance(K.M) :
Nearest Railway Station :
Station Distance(K.M) :
Nearest Bus Stand :
Bus Stand Distance(K.M) :