Institute of
Cheminformatics Studies
EXAMINATION FORM
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NO COLUMN SHOULD BE LEFT BLANK (ALL IN BLOCK LETTERS)

Course applied for: Post Graduate Diploma in .................................

1. Enrollment No. * __________________________________
2. Name of the Candidate ___________   __________   __________
3. E-mail __________________________________
4. Address for Correspondence __________________________________
  City __________________________________
  State __________________________________
  Pin __________________________________
6. Crossed Demand DraftNo.____________dated__________Drawn on__________________ for Rs.**_____________________________________________
  (Bank draft must be drawn in favour of Institute of Cheminformatics Studies payable at New Delhi / Delhi Candidates are advised to write their name and address at the back of demand draft)

 

Date : _____________
(SIGNATURE OF THE CANDIDATE)
Place : _____________

* As provided by the institute at the time of registration
** Exam Fee is @ Rs. 200/paper i.e. Rs. 1600 or @ USD 35 per paper i.e. USD 280 (for overseas students)

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