English Language Enrichment Course for Primary - Level 1 (ELEC-L1) Enrollment Form
Full Name
*
(Write full name, the same will appear in the certificate)
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First name should contain alphabets
Designation
*
--Select--
Gazetted Headmaster
School Assistant
PS HM
Secondary Grade Teacher
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Email Address
*
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Email address is required.
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Invalid email format.
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Given email address is already registered with us.Please try with any other email address.
Mobile No.
*
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Mobile number is required.
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Enter a valid 10 digit mobile number.
Gender
*
Male
Female
Others
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Experience of teaching (in years)
*
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Experience should be in numbers.
U-DISE number of your school
*
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Please enter a valid number.
Employee ID (Treasury ID)
*
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Please enter a valid number.
District
*
--Select--
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Mandal
*
--Select--
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Name of the School
*
(Write the name of your school, name of the Mandal and the district where your school is located. Same will appear in the certificate)
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Training Center
*
--Select--
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Others Venue
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Training Spell
*
--Select Spell--
I (21-3-2022 TO 16-04-2022)
II (28-3-2022 TO 23-04-2022)
III (04-04-2022 TO 30-04-2022)
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Role
*
--Select--
KRP
Mentor
Participant
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Highest Qualification (Academic)
*
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Highest Qualification (Professional)
*
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Which subjects do you teach in school?
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Social studies
Physical Science
Biological Science
Mathematics
Primary School Subjects
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Did you study in English medium at any of your school stage?
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Yes
No
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Do you have a smartphone?
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Yes
No
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Do you have internet data to browse the course content online?
*
Yes
No
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Will you be available for the entire duration of the course? No extra grace period will be given. 9 weeks course will be conducted in 9 weeks duration only.
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Yes
No
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What is your expectation from this course?
*
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Declaration
The information given by me in this form is true. I understand that any false information furnished by me will lead to the permanent cancellation of my participation in this course.
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Agree
Disagree
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