UGC - Malaviya Mission Teacher Training Centre
Punjabi University Patiala


APPLICATION FORM FOR ORIENTATION/REFRESHER COURSE
 
Please read the Instructions before filling in this form:
(a) The Registration fee for the course is R. 1000/- (One Thousand only) to be paid through online payment mode after his/her selection

Account Name: Director, Human Resource Development Centre, Punjabi University, Patiala
Account Number 65067372627
IFSC Code SBIN0050009
MICQ: 147002022

(b) This form must be filled in completely and no column should be left blank.
(c) This form must be forwarded through proper channel.
(d) Strike out which is not applicable.
(e) Teachers will pay the registration fee online or through Draft only after getting the selection letter.
(f) Every teacher is required to present a research paper during the course.
(g) Certificates of completion of course will be sendthrough speed post to those participants who attend the course for the full duration i.e. 25 working days for FIP and 12 Working days and 72 Hours for RC. There is no provision of any kind of leave.
(h) Application form should be addressed to Director, Human Resource Development Centre (HRDC), Punjabi University, Patiala - 147002.
Select a Programme :
Course Name : OP (General)/OP (IT)/Refresher Course in
Dates :  to
   
 
1.
*Name :      
2.
*Date of Birth :     *Gender :   



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3.
*Category :  
4.
*Qualification :     *Subject :    
 
*Specialization :     
5.
Phone (with STD code) : (R)   *(M)    
 
Fax :   *E-mail :      
6.
*College/University     *Affiliating University    *Place :    
 
*Type of Institution :  
7.
*College Recognise under Section 12B and 2F  
8.
*College Affiliation From :    
9.
*Designation :     
10.
*Due Date of Promotion :  /  /
11.
*Nature of Appointment :  
12.
*Teaching Experience :     Years   Months
13.
Scale of Pay :    Basis Pay :    or, Fixed Pay :  
14.
*Official Address :  
Department:   Name of Institute:   Place: 
 
Tehsil:   District:    State:    Pin:  
15.
*Correspondence Address :    
  (all the communication will be on correspondence address)
So kindly fill complete address including house no, city, tehsil, district, pin code so that certificate etc. may be delivered appropriately
16. Details of the Orientation and Refresher Courses attended:
   
 
Course Date and Duration Institution
Orientation Course
Refresher Course 1
Refresher Course 2
Refresher Course 3
17.
*Whether accomodation is required :