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GLOBAL INSTITUTE OF SOCIAL SCIENCES POST GRADUATE CERTIFIACTE COURSE DEPARTMENT Contact address ED 130 RAJDANGA MAIN ROAD KOLKATA 700 042 PH 24416453 9830249182 e mail gisskolkata gmail.com APPLICATION FOR ADMISSION TO Affix your recent Photograph here Please the Selected Course 6 MONTHS POST GRADUATE CERTIFICATE COURSE IN Social Welfare Administration Child Protection 1. Name of the Course 2. Name in capital letters Sex 3. Date of Birth 4. Nationality DD MM YYYY 5. Present Residential Address Block letters State Pin code Telephone no Email ID 6. Permanent Address 7. Academic Qualifications Class X Examination to Degree courses Details of School exams and Degree courses Year of Passing Board/University Name of the School/college Class obtained 8. If presently employed please furnish the following Name of the Institution Designation From To 9. Why you would like to join the course 250 words Declaration I hereby declare that all the above information provided by me is true to the best of my knowledge. I understand that my admission will stand cancelled if any discrepancy is found in the above information at any stage. Name of the Course 2. Name in capital letters Sex 3. Date of Birth 4. Nationality DD MM YYYY 5. Present Residential Address Block letters State Pin code Telephone no Email ID 6. Permanent Address 7. Present Residential Address Block letters State Pin code Telephone no Email ID 6. Permanent Address 7. Academic Qualifications Class X Examination to Degree courses Details of School exams and Degree courses Year of Passing Board/University Name of the School/college Class obtained 8. Academic Qualifications Class X Examination to Degree courses Details of School exams and Degree courses Year of Passing Board/University Name of the School/college Class obtained 8. If presently employed please furnish the following Name of the Institution Designation From To 9. Why you would like to join the course 250 words Declaration I hereby declare that all the above information provided by me is true to the best of my knowledge. If presently employed please furnish the following Name of the Institution Designation From To 9. Why you would like to join the course 250 words Declaration I hereby declare that all the above information provided by me is true to the best of my knowledge. I understand that my admission will stand cancelled if any discrepancy is found in the above information at any stage. Name of the Course 2. Name in capital letters Sex 3. Date of Birth 4. Nationality DD MM YYYY 5. Present Residential Address Block letters State Pin code Telephone no Email ID 6. Permanent Address 7. Academic Qualifications Class X Examination to Degree courses Details of School exams and Degree courses Year of Passing Board/University Name of the School/college Class obtained 8. Present Residential Address Block letters State Pin code Telephone no Email ID 6. Permanent Address 7. Academic Qualifications Class X Examination to Degree courses Details of School exams and Degree courses Year of Passing Board/University Name of the School/college Class obtained 8. If presently employed please furnish the following Name of the Institution Designation From To 9. Why you would like to join the course 250 words Declaration I hereby declare that all the above information provided by me is true to the best of my knowledge.

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