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Faculty Management Development Program
Registration for Faculty Management Development Program
Program Name
*
Select
Name of the Candidate (Which will be printed on the Participation Certificate)
*
State of the Candidate
*
GOA
District of the Candidate
*
Select District
North Goa
South Goa
Taluka
*
Select Taluka
Address
Mobile Number
*
Email Id
*
Gender
Select
Male
Female
Other
Age
*
Select
18-25
25-35
35-45
45-55
55 and Above
Social Category
*
Select
General
SC
ST
Other
Education Qualification
*
Select
Illiterate
Less than 10th (Secondary)
10-12th (Higher Secondary)
ITI
Polytechnic
Graduate
Post Graduate and Above
Aadhar Number
PWD/Normal
Preferred Meal
Select
Veg
Non-Veg
Awareness about the program?
*
Select
EDII Website
Call from EDII staff
Social Media
Friends Referral
Nomination from Company (if working in organisation)
E-Mail
EDC Officials
College/ University
Other
Select Department
*
Select
Directorate Higher Education (DHE)
Directorate Technical Education (DTE)
Directorate of Skill Development and Entrepreneurship (DSDE)
Directorate of Education (DE)
Private
Name of College
*
Select
Education stream
*
Select
Science
Arts
Commerce
Engineering
Technical-ITI
Faculty ID
*
Select ID proof (PAN Card/Aadhar Card/Voter ID/ Driving Licence/ Employee ID)
The information provided above is true and correct to the best of my knowledge.
*
I Agree
Submit
