Consultancy Development Centre

IT Consulting Program at CDC

3 months Certificate Program for Working Professionals

Consultancy Development Centre (CDC)

An Autonomous Institution of DSIR, Ministry of Science & Technology,Govt. of India

NOMINATION FORM

(July-September 2017 Batch)

Name

Address for communication

Phone (Off) Mobile

Email

Academic Record

Degree/ Diploma / University / Experience / Specialization, if any

Details of Present Employment(if applicable)

Designation

Organisation/ Department

Address of the Employer

Name of theBank with payment details

DECLARATION BY THE CANDIDATE

I hereby declare that all the statements made in this application are true, complete and correct to the best of my knowledge. In the event of any information being found false or incorrect or ineligibility being detected before or after the examination, action may be taken by the Consultancy Development Centre as deemed fit, against me. Once fee is deposited and admission is done than the fee will not be refunded.

Date Signature

ENCLOSE FOLLOWING DOCUMENTS ALONGWITH NOMINATION

1. Demand Draft for admission fee (along with service tax as applicable at the time of submission of the application form) in favour of Consultancy Development Centre, New Delhi
2. Self attested Xerox of the Degree/ Diploma Certificate issued by the University/ College/ Institute in support of eligibility. Equivalent qualification proof need to be submitted from Competent Authority.
3. Certificate from institute in support of being a final year student (in case of final year students)
4. Certificate issued by competent authority in support of OBC/ SC/ ST candidate/Physically Handicapped Student.
5. AADHAR CARD’s Xerox (self attested) required under Govt. of India’s latest initiative of Direct Benefit Transfer (DBT) for transfer of funds or services in kind to beneficiaries.

BANK DETAILS FOR PAYMENT OF PROGRAM FEE THRO ECS/ RTGS

Name of the Account Holder / Consultancy Development Centre
Beneficiary Address / Core – 4 B, IInd Floor, India Habitat Centre
Lodi Road, New Delhi – 110 003
Phone Number / 011-24602601, 24602915, 24601533
Bank Name / Bank of Baroda
Branch Name and Address / Bhogal, New Delhi Extension Counter,
Air Force Bal Bharti School, Lodi Road,
New Delhi – 110 003, Phone : 24625819
9 Digit MICR Code Number of Branch / 110012105
Type of Account / Current Account
BSR Code of Bank (4 digit code) / 0202976
Account Number (15 digit code) in digit / 98010200006844
Account Number (15 digit code) in word / Nine/ eight/ zero/ one/ zero/ two/ zero/ zero/ zero/
zero/ six/ eight/ forty/ four
IFSC Code / BARB0(zero)XTBHOG
Customer ID / 010800860
Whether this branch is RTGS enabled / YES

Note :Demand Draft may be drawn in favour of “Consultancy Development Centre”, payable at New Delhi. For online transfer of program fee, kindly refer the bank details.

Nominations may be sent by e-mail at . For further details, please refer our website: section “WHAT’S NEW” or “Courses Offered” or contact the Program Coordinator, Ms.Seema Sachdeva, Tel.No.011-24602601, 24602915, 24601533, Fax:011-24602602.

CONSULTANCY DEVELOPMENT CENTRE

An Autonomous Institution of DSIR, Ministry of Science & Technology, Govt. of India

India Habitat Centre, Core – IV B, 2nd Floor, Lodhi Road, New Delhi – 110 003

Phone : 24602601, 24601533, 24602915, Fax : 24602602