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.
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 :
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) :