District Coordinator Application Form

Application For District Coordinator for(District Name)

First Name

Last Name

Mobile Number

Email id

Training Center Name(if any)

Legal Status of Training Center

Training Center Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Whether your Training Center is Currently Associated/Franchise/Partner with any Organization(if any please specify name)

Training Center Location

Proximity to Public Transport System from Training Center

Name of the Nearest Bus Stop/Bus Stand/Metro Station/Railway Station

Total Carpet Area of Training Center

Total Number of Computer System Available for Training Purpose

Courses Currently being conducted at your Training Center

Personal Details of Training Center Head

First Name

Last Name

Father Name

Date of Birth

Residence Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Contact Number

Email id

Education Qualification

UNDERTAKING

I Understood the Rules and Regulations as of now amended in future applicable to the institute conducting IISDT or its collaborative Partners Courses explained in the Training Partner Proposal for Affiliation agreed to abide the same. 1. I certify that I am the competent authority, by virtue of the administrative and financial power vested in me of the above mentioned institute/organization to furnish the above information and to undertake the above stated commitment on behalf of my/our institution. 2. I am aware that in case of any information given by me is false or misleading, IISDT may in its sole discretion can take whatever actions or measures it deems necessary and appropriate and the institute would be debarred from the affiliation. 3. I agree to abide by the Rules and Regulations and the decisions taken by the management of the IISDT from time to time. 4. I further understand that, I have to register each and every trainees/Students studying at my/our center at IISDT Head office by paying the prescribed Exam fee, failing which IISDT will have all the rights to take action. 5. In case of any dispute arising IISDT and its Training Partner the Jurisdiction for all legal Purposes will be INDORE, M.P., INDIA only.