Symbiosis Letter

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Centre for Distance Learning (SCDL)


Symbiosis Bhavan, 1065 B, Gokhale Cross Road, Model Colony, Pune -- 411016, Maharashtra, India. Tel. 020 66211000 I Fax: 020 66211040 I 41 I

Please read the instructions before filling the form Application Form For Admission 2011 Application No. 27274

To, The Director, I request for grant of admission to the below mentioned program being offered by your institute for the academic year starting from July 2011.

A Personal Details


Name of the applicant should be as per Degree /

Paste one recent passport size colour photo & attach another photo at the top right corner

Diploma Certificate attached / Diploma Certificate attached. In case of name change, attach the required document.)

Last Name: First Name: Middle Name: Date of Birth: dd mm yyyy Gender: Male Female

(IN BLOCK LETTERS) Please use spaces and / or commas wherever applicable. B Address (Students should take utmost care in writing complete address so as to receive all commmunication, Study kit, ID Communication Address: on this address without any delay. Re-dispatch due to incorrect address will be at an extra cost to be paid by the student.)


Taluka: City: Country: Tel. No: Email: State:


Pin Code: Mobile No:

(Ensure your contact no. is correctly recorded as SCDL sends important messages via SMS. Any change in Address / Contact No. / Email must be communicated to SCDL immediately.)

Permanent Address: Address:

Taluka: City: Country: Tel. No: Email: State:


Pin Code: Mobile No:

(Signature of Applicant)
1 of 5

Are you an active student of SCDL? If yes please write your registration no. C Student Category Defence Para - Military General / Civil International Student D Programs

Police Symbiosis Employee / Staff

SAARC Countries

Category 1

Tick the appropriate Program / Course. Student can register for only one PG program at a time. Students can not enroll for single courses (Category - 2) and Programs (Category - 1) at a same time.

h Two-Year Post Graduate Diploma Programs

Post Graduate Diploma in Business Administration (PGDBA) with specialization in ( only one specialization) Marketing Human Resources Finance Operations CRM Post Graduate Diploma in International Business (PGDIB) Post Graduate Diploma in Information Technology (PGDIT) Post Graduate Diploma in Educational Administration (PGDEA) Post Graduate Diploma in Banking & Finance (PGDBF) Post Graduate Diploma in Insurance Management (PGDIM) with specialization in ( General Insurance Life Insurance Post Graduate Diploma in Human Resource Management (PGDHRM) Post Graduate Diploma in Retail Management (PGDRM) Post Graduate Diploma in Customer Relationship Management (PGDCRM) Post Graduate Diploma in Supply Chain Management (PGDSCM) Post Graduate Diploma in Instructional Design (PGDID) Post Graduate Diploma in Pre-Primary Teacher's Training (PGDPTT) Post Graduate Diploma in Technical Writing (PGDTW) Post Graduate Diploma in Export Import Management (PGDEXIM) Post Graduate Diploma in Business & Corporate law (PGDBCl) Advanced Diploma in Creative Writing in English (ADCW) Diploma in Creative Writing in English (DCW) Diploma in Teaching English (DTE)


h One-Year Post Graduate Diploma Programs

aonly one specialization)

One-Year Diploma Programs

Six-Month Certificate Programs
Certificate Program in Entrepreneurship Development and New Venture Creation (CPENVC) Certificate Program in Right to Information Act (CPRTI) Certificate Program in Consumer Protection Act (CPCPA) Certificate Program in Cyber laws (CPCl)

Category 2 (Students enrolling for category 1 Programs can not seek admission to Category 2 Single Courses) Single-Courses: Maximum four courses can be selected at a time. SCDL has introduced admissions to single courses, (refer our website, course & eligiblity) Please write course

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