75-Batch Last date for Submission of completed Application Form: is 31st May, 2016

Commencing from 1st July, 2016

ADMISSION FORM
REGISTRATION NO.

APPLICATION NO.

Programme Officer, Diploma Programme

Indian Society for Training & Development
Training House
B-23 Qutab Institutional Area, New Mehrauli Road
New Delhi 110 016
Phones: 011-26867710, 26857157 Fax: 011-26867607
Email: istd@nic.in / istdprog@gmail.com
Website: istd.co.in

Affix here a stamp size

Photograph and attach
one more copy which will
be affixed to your identity
card, issued by the
Diploma Office, will be
required for appearing at
the examination.

1.

Full Name: Shri/Smt./Kumari: ..

(Surname)
(First Name) (Middle Name)

2.

Fathers/Mothers/Husbands Name: ..

3.

Date of Birth: ..
(DAY)

4.

(MONTH)

(YEAR)

Address for Correspondence (in Block Letters): ..

..
......
Town/City: ..State: Pin.
Telephone: (Office) ...Residence.....
Mobile: ..Email: ..
5.

Academic & Professional Qualification: (start with highest degree)

University/Institution

Degree/Diploma

Duration

Year of Passing

A.
B.
C.
D.
(Attested Copies of University Degree/Professional Qualification must be enclosed)
6.

Present Occupation:
a.

Designation.....

b.

Name & Address of Employer Organisation......

Date:

(Signature of Applicant)

/2/
7.

Details of Experience: In case of Graduate Degree or its equivalent, and have a minimum two
years work experience in Training/Human Resource Development function, attested by
Department head must be attached separately or given here:
Organisation

Post held
Training Functions

Years

Experience
Months

NAME:
DESIGNATION:
Attested by Department Head : SIGNATURE AND SEAL
8.

a) Enclosures:
1.

4.

2.

5.

3.

6.

b) I also enclose herewith :

i)

Rs. 500/- towards Prospectus Fee.

ii)

Rs. 1000/- towards Registration Fee

iii)

Rs.45,000/- towards full Course fee/ Rs.15,500/- towards First Instalment of Course Fee. In
case of Armed Forces Officials Rs.25,000/- towards full Course fee/Rs.12,800/- towards First
Installment of Course Fee.

iv)

Rs. 40,500/- towards full Course Fee for ISTD Permanent Institutional Members in one
lumpsum
Rs.40,500/- towards full Course fee/ Rs.14,000/- towards First Instalment of Course Fee for
SC/ST Candidates .

9.

v)

Demand Draft No.dated ..for Rs. The Draft should be

in favour of ISTD (Diploma Programme) payable at New Delhi

vi)

If you are eligible, you can make a single draft for the total amount

I certify that the above particulars are correct to the best of my knowledge.

Date:

(Signature of Applicant)
FOR OFFICE USE ONLY

Status; Training Experience Certificate/Ed. Certificate (s) required

ADMIT/ NOT ELIGIBLE

Member Secretary
Diploma Programme
How did you come to know about ISTD Diploma Programme/through a News Paper/Brochure/Website/
ISTD Member/Chapter/Collegue/Diploma Student/Any other.