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fdp registration form.pdf - Jrnrvu

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EMPLOYEE DETAILS (STARTING FROM THE RECENT, ATTACH SEPARATE SHEET IF<br />

NEEDED)<br />

DESIGNATION ORGANIZATION RESPONSIBILITIES PERIOD<br />

FROM TO<br />

TEACHING<br />

INTERESTS<br />

RESEARCH<br />

INTERESTS<br />

C.PROFESSIONAL EXPERIENCE:<br />

TOTAL DURATION OF TEACHING<br />

EXPERIENCE<br />

TOTAL DURATION OF NON<br />

TEACHING EXPERIENCE<br />

TOTAL EXPERIENCE<br />

I , …………………………………………………………………………..,hereby declare & certify that,<br />

1. All the in<strong>form</strong>ation provided above is true to the best of my knowledge and i am liable<br />

to produce proof of such in<strong>form</strong>ation on demand.<br />

2. I have read & understood the programme brochure. I agree to abide by the<br />

programme and institute rules.<br />

3. I am medically fit to take part in the programme and do not suffer from any medical<br />

illness or condition.<br />

DATE…………………………..PLACE……………………………….SIGNATURE………………………………

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