9.9 School of Convergence,World Class Media Education in India,Journalism Colleges India,Mass Communication Colleges,International Journalism Courses,World Class Media Institute India

APPLICATION FORM ADMISSION, 2012-13

PERSONAL DETAILS

Attach Your Photo^*

1 Surname/Family^*

2 First Name ^*

3 Title (Mr/Mrs/Ms)^*

4 Date of Birth ^*

5 Gender ^*

6 E-Mail ID ^*

7 Fixed Line nos.

8 Mobile No. ^*

9 Residential Address ^*

EDUCATIONAL QUALIFICATION, ALREADY OBTAINED / ON GOING

10. Details of your education from Class XII. Start with the most recent one, and then
move backward.^*

Name of College/ University/School	Start Date Month/Year	End Date Month/Year	Qualification e.g. BA (Eco), M.com	Overall %	Major Subjects

EMPLOYMENT

11. List of all your major employments till date. (Full & Part time)

You may include a copy of your curriculum vitae if that is more convenient.

No. of Employer^*	Start date^*	End Date^*	Position Held^*

12. Essay (short the better): What do you want to do in life and how can one year at 9.9 School of Convergence help you achieve that?^*

13. What means the most to you and why? (50 words)^*

14. Please mark the courses you wish to apply for:

Post Graduate Diploma in Applied Journalism and Media Communication
Post Graduate Diploma in Digital Media Communication

15. DOCUMENT UPLOAD

Completed application form has to be submitted to

9.9 School of Convergence c/o Sri Aurobindo Society,
New Mehrauli Road, Adchini, New Delhi - 110 017

Fill in the form and send it to us with a processing fee of Rs. 1,000 either in cash
or draft in favour of ‘Nine Dot Nine Mediaworx Pvt Ltd’ Payable at Delhi. (At the above mentioned address)

Checklist of documents to be submitted with the form

Copies of academic transcripts from previous academic institutes attended (self attested)
ID proof (can be a copy of driving license, passport copy, voters ID, or photo id proof).
Two color photographs (One color photo graph on the application form with a signature across the photograph) with the name at the back of the pictures.
Processing fee of Rs1000 in cash or draft in favour of Nine Dot Nine
Mediaworx Pvt. Ltd.
Any collaterals like pieces of writing or videos that you may want to submit.

Term & Conditions

Application form once sold / issued in the name of candidate cannot be returned and/or transferred.
9.9 School of Convergence and SACAC reserve the right to call applicants for interview.
Application form should be complete in all respects.
Rights to admission are reserved with 9.9 School of Convergence and SACAC.
Fee once paid is non-refundable and non-transferrable.
All disputes are subjects to the exclusive jurisdiction of Delhi Courts.

For queries related to admission contact +91 9717 999 612
email admissions@schoolofconvergence.com

Note: Incomplete forms will not be considered

Declarations : I confirm that the information on this form is complete and that all essential information has been included

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