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EQUAL OPPORTUNITY CELL DU-NTPC FOUNDATION ICT TRAINING CENTRE University of Delhi, Delhi 110007 Application Form 2011

1 Paste your recent passport size Capacity Building Classes for Students with photograph Disabilities 1. Name: 2. Fathers/ Guardians Name: 3. Mothers Name: 4. Address: 5. Phone: 6. E-mail: 7. DOB: 8. Sex : 9. Qualifications: Give details of last exam passed only Exam Board/ Subjects University

Percentage/ Grade

Year

10. Type of Disability with % : 11. Total family income per month: Documents to be attached (self attested): 1. Proof of last examination passed 2. Proof of Disability certificate 3. Proof of Income certificate 4. 2 Passport size photographs along with the form

Signature/ Thumb Impression: Date:

For more information contact Equal Opportunity Cell on Ph: 27662602 or send email to eoc@du.ac.in

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