1.Details of Institution :
Program Applied For :
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Name of the Institution :
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Name of the Parent Body :
Year of Establishment :
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Registration No :
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District :
State :
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Institute Head Name :
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Institute Head Designation :
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E-mail ID :
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Alternate E-mail :
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Proof of Identity(Identitiy Card/Passport) :
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Website Address :
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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 :
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City :
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Postal Code :
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State :
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Country :
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Office Number :
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Mobile Number :
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Correspondence Address :
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City :
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Postal Code :
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State :
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Country :
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Office Number :
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Mobile Number :
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4.About Location :
Prime Location :
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Total Carpet Area(In Sq.ft) :
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5.Connectivity :
Nearest Airport Name :
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Airport Distance(K.M) :
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Nearest Railway Station :
Station Distance(K.M) :
Nearest Bus Stand :
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Bus Stand Distance(K.M) :
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