Application Form for XCOMM Summer Media Courses
Last date to apply for the course is April 10th, 2017
Course Applied For:
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Applicant Name:
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Email ID:
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Alternative Email ID :
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Mobile Number :
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Alternate Phone Number :
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Gender :
Date of Birth :
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Father's / Guardian's Name :
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Present Address (for correspondence) :
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Permanent Address :
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Academic Details
Highest Qualifications attained :
Degree / Certificate Name :
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University /College /Institute /School Name :
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Discipline / Subjects :
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Other Qualifications if any?
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Accommodation :
Accomodation on Twin-Sharing basis is available at Rs. 2000/- per candidate (for the course duration, excluding food)
Amount Paid for :
Payments can be made via NEFT / DD in favour of " Xavier University SOC "
Course Fee :
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Accommodation Fee:
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Bank Details :
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DD No / Transaction ID :
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This Application will be complete only with the payment of full course fee. Please send an email with all the payments details to summercourse@xcomm.edu.in
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