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APPLICATION FOR APPROVAL OF LEARNING CENTRES
Centre Opted For
A.
Master Learning Center
B.
Learning Center
Name of the study Center
Address
City
State
Select
Andaman and Nicobar Islands
Andaman and Nicobar Islands
Andhra Pradesh
Andhra Pradesh
Arunachal Pradesh
Arunachal Pradesh
Assam
Assam
Bihar
Bihar
Chandigarh
Chandigarh
Chhattisgarh
Chhattisgarh
Dadar and Nagar Haveli
Dadar and Nagar Haveli
Daman and Diu
Daman and Diu
Delhi
Delhi
Goa
Goa
Gujarat
Gujarat
Haryana
Haryana
Himachal Pradesh
Himachal Pradesh
Jammu and Kashmir
Jammu and Kashmir
Jharkhand
Jharkhand
Karnataka
Karnataka
Kerala
Kerala
Lakshadeep
Lakshadeep
Maharashtra
Maharashtra
Meghalaya
Meghalaya
Nagaland
Nagaland
Orissa
Orissa
Puducherry
Puducherry
Punjab
Punjab
Tamil Nadu
Tamil Nadu
Tripura
Tripura
Uttar Pradesh
Uttar Pradesh
Uttarakhand
Uttarakhand
West Bengal
West Bengal
Name of the Person Solely Responsible for the study center
Address
E-mail ID
Contact Number
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Study Center login Username
Study Center login Password
Confirm Password
Facility Available at the Study Centre
No. of Class Rooms
(Specify seating capacity in each classroom)
No. of Systems.
(Computer)
Broadband Connection
No. of Student Counselors
Experience with other Distance Education
(IF you please specity the name of the direcorates at present you are associated with and the name of the programmes you have enrolled).
Total Work Experience During Studies
Amount of Deposit to be deposited as security deposit
DECLARATION
I declare that all the information submitted in this application form is correct and complete. I acknowledge that ITMS reserves the right to vary or reverse any decision regarding on the basis of incorrect or incomplete information provided by me. I declare further that I had read and understood all the contents os this application and the terms of the Contract which I have signed with ITMS. I also agree tho comply with rules and regulations of ITMS that may be applicable from time to time.
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