ENTREPRENEURSHIP DEVELOPMENT INSTITUTE OF INDIA

DIPLOMA IN ENTREPRENEURSHIP & BUSINESS MANAGEMENT

APPLICATION FORM

Application for the batch: January

(Tick in the appro.box)
April

July

October

1.0 Name : Mr./Mrs./Ms/

Address for communication:

Pin: Tel. No. (with S T D code):

E – mail:

1.1 Permanent Address:

Pin: Tel. No. (with S T D code):

E – mail:

2.0 Date of Birth: Date Month Year

2.1 Age:
3.0 Religion:

4.0 Medium: English Gujarati

5.0 Educational Qualification:

Stream Year University/Board

Post Graduate

Graduate

Diploma

Non-graduate

6.0 Work Experience:

Name of Organisation Nature of work Duration (yrs.)

7.0 Present Occupation : ( tick in the appropriate box)

Study

Service

Business

Housewife

Others

8.0 Family Background : ( tick in the appropriate box)

Service

Business

Others

No formal
Involvement in income generating activity
9.0 How did you come to know about this course?

Newspaper

Personal contact

Counsellor/nodal agency

Others

10.0 Which city would you prefer for counseling services? Give three choices.

1.
2.
3.

11.0 Details of fee:

Cash / Demand draft

Demand draft no.

Name of Bank and date

For Rs.*

Date: Place: Signature:

Please send duly filled-in application form, with two stamp size photographs, proof of
educational qualification and programme fee to:

OPEN LEARNING DIVISION

ENTREPRENEURSHIP DEVELOPMENT INSTITUTE OF INDIA
VIA INDIRA BRIDGE, P.O. BHAT – 382 428, DIST GANDHINAGAR,
GUJARAT

TEL : 079-23969161, 23969163 FAX : 079-23969164

E-MAIL: olpe@ediindia.org

* Learners submitting this online form must add Rs.250/- to the total
fee, towards the cost of prospectus-cum-application form.