IIJNM School of Continuing Education

Registration Form for Short-term Course

Personal Identification

  
Full Name : You must enter your full name.
Date of birth :  
Sex: Male Female  
Tel/Mobile No: Phone is required.Invalid format. Enter your phone number  
E-Mail: Email address is requiredPlease enter your email in correct form.  
Confirm E-Mail: Email address is required Please enter your email in correct form.
 
   
Current Mailing Address  
 
Please enter your current mailing address.		  
   
Pin Code: Please enter your area Pin Code.Only Pin Code accepted.  
     
Nationality: Enter your country of residence.  
 
Select one course (Rs. 35,000): Effective Business Writing  
Professional Writing for Media  
Becoming an Effective Citizen Journalist  
  Audio and Video Editing  
  Using Multimedia Tools in Journalism  
     
Select one session: Session 1: Oct 23, 2010 to Nov 28, 2010  
  Session 2: Jan 15, 2011 to Feb 20, 2011  
     
Wish to use institute conveyance
( Rs. 3,000) 		Yes No  
Wish to have institute lunch
(Rs. 1,000 )		 Yes No  
 
   
All the above entered parameters are true and accurate to the best of my knowledge.