Practice Learning Certificate Course
Application Form
Email *
Mobile number *
1. Your Name (First, Last) *
2. State *
3. Country *
4. Are you a student or currently working? *
5. What is your education level?
Graduation completed/pursuing
Postgraduate completed/pursuing
PhD completed/pursuing
Science/Medical/Public Health/Paramedical/related
Arts/Social Science/Population Sciences/related
Statistics/IT/Mathematics
Business/Management
Anyother
6. Name of your university (if you are a student) / Name of your organization (if you are working) with a complete address (District, State, Country)? *
7. Which course/s you are interested in? *
Required
8. Your preferred days for the course. *
Required
8. Timeslot preference *
Required
9. Why do you want to attend the course? How it is going to help you? *
Submit
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