GETS

Application form
GIS & RS Short term Course
geo-environmental & technical services

Form No. :
PHOTO

Personal Information
Name : _____________________________________________________________
Fathers Name : _______________________________________________________
Date of birth : Gender : OTHER

Marital status : Widowed

Correspondence Address: ______________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_______________________________________________________ Postal Code : _________________
Telephone : _____________________________ E-mail : _____________________________

Educational record
Enter information about your highest educational level achieved. Also, please include a certified copy of the achieved diploma, certificate,
degree or course record.
Qualifications: Diploma B.Sc. M.Sc. PhD Others ______________
Subject Specialisation: ___________________________________________________________________
Name of institute : ______________________________________________year_____________________

Employment record (If any)

Job title : ___________________________________________________________________________
Organisation Name : __________________________________________________________________
Dept/Division/Office name : ____________________________________________________________

GIS & RS Knowledge and skills

I have followed extensive GIS training and/or work regularly with GIS software, namely ________________
I have only a basic awareness of GIS / Remote Sensing
I have no experience with GIS software / Remote Sensing

Payment Mode
(Kindly fill-in your payment details here: (It is advisable to upload the scanned copies of the payment document)
Cash Cheque/DD No. ________/ Dt:

Undersignment
DECLARATION
The above furnished information is true to the best of my knowledge and in case of any-
thing found misleading or wrong my candidature is liable to be rejected without any notice.

Date : Place_______________ Signature of applicant