The Environmental Planning & Coordination Organisation

PGDEM 2024-25 Online Application Form

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PGDEM 2024-25 Online Application Form

Upload Photo*Max upload size 1MB

Name of the Candidate*

Email Id*

Date of Birth*

Mobile Number*

Photo Id type*

Photo Id detail*

Father’s Name*

Mother’s Name*

Gender*

Category*

Landline

Address for Correspondence*

State*

City*

Pin Code*

Reference * Please add name , address , email and phone number of your Reference

Educational Qualification

S. No.	Qualification	Board/University	Subjects/Topics	Year of Passing		Total Marks	Marks Obtained	Percentage/Grade
1	10^th*
2	12^th*
3	Graduation*
4	Post Graduation

S. No.	Qualification	Institute/University	Title/Topics	Year of Award
5	M.Phil
6	Ph.D
7	Any Published Research Papers/Article
8	Education Certificates, Experience Certificate, Caste Certificate,Photo ID, NoC of Employer for In service applicant to take up this course and Eminent professionals reference shall be uploaded in single PDF*Max upload document size 10 MB

Present Assignment (For In-service Candidates only)

Name of Organization	Contact Details of Employer(Address, Phone, Email)	Designation of Candidate	Date of Joining

Application Fee Details (Clearly specify mode of payment) payment details for NEFT/RTGS shall be given
Account Name	Amount	Account No.	Bank Name & Branch
EPCO Institute of Environmental Studies ,Bhopal	Rs. 1000/-	6310001100000028	Punjab National Bank, EPCO Branch, Bhopal IFSC Code : PUNB0631000

Payment reference number*

Payment Date*

I hereby confirm that the above mentioned details are true to the best of my knowledge. I undertake that I will abide by the rules & regulations of the Institute.

EPCO

PGDEM 2024-25 Online Application Form

Educational Qualification

Present Assignment (For In-service Candidates only)