Online Application Form for the Post Graduate Program in Media & Entertainement

Please complete and submit the form below. There are 2 sections to the form. You will be prompted, as you move from one section to another.

You will be able to edit the form in the future, until the application process is on.

The changed status of your registration, indicated by the "registered" button to the right, will be reflected, the next time you log in to the module.

In case you experience any difficulty while filling the form, you can mail us on
 pgpmedia@welingkarmail.org

Section 1
(Fields marked '*' are mandatory)
   
First Name *:
Middle Name :
Last Name * :
Email ID * :
Ensure to enter a valid Email ID.
Future correspondence will be done on this Email ID.
Gender * :  Male    Female
Marital Status *:  Married   Single
Date of Birth *:
Mobile No.
Mother Tongue * :
Caste/Sub caste :
 
 
Address for Correspondence *
 
Address Line 1 :
Address Line 2 :
Address Line 3 :
City :
Pin :
State :
Phone :    -   
 
Permanent Address
(If same as correspondence)
Address Line 1 :
Address Line 2 :
Address Line 3 :
City :
Pin :
State :
Phone :    -   
 
Parent's / Guardian's Address
(If same as correspondence)
Address Line 1 :
Address Line 2 :
Address Line 3 :
City :
Pin :
State :
Phone :    -   

 Please check all the details before submitting the form.