URDU ACADEMY, DELHI (Govt. of Delhi) APPLICATION FORM URDU CERTIFICATE COURSE 2018-19 (Recognised by University of Delhi) 1. Name (in block letters) : ------------------------------------------------------------------------------------------------ 2. Father's / Husband's Name : ------------------------------------------------------------------------------------------------ 3. Date of Birth : ------------------------------------------------------------------------------------------------ 4. Qualification : -------------------------------------Profession & Official address ---------------------- ------------------------------------------------------------------------------------------------- 5. Postal Address (in block letters) : ----------------------------------------------------------------------------------------------- Mobile & Phone No.:---------------------------------------------------------------------------------- 6. Centres ( Kindly tick the Centre of your choice) JANAKPURI KASHMERE GATE LAXMI NAGAR MAYUR VIHAR NIZAMUDDIN QIDWAI NAGAR YAMUNA VIHAR Certified that I have not studied Urdu at any stage. If this statement is found incorrect the admission can be revoked. Date:------------------- ( Signature of applicant ) Note : Please attach the Photocopy of the Certificate / Degree last obtained ( For office use only ) Mr./Mrs./Miss------------------------------------------------------------------------ is admitted in Urdu Certificate Course for the session 2018-19 at -----------------------------------------------------------------Centre Secretary Urdu Academy, Delhi ------------------------------------------------------------------------------------------------------------------------------------------------- Name of the Candidate __________________________________ CLASSES WILL BE HELD ON THE FOLLOWING CENTRES: 1. JANAKPURI CENTRE : Sumermal Jain Public School, B-2 Block, Janakpuri, New Delhi-110058. 2. KASHMERE GATE CENTRE : Urdu Academy, CPO Building, Kashmere Gate, Delhi / 3. LAXMI NAGAR CENTRE : Bharti Public School, Swasthaya Vihar, Opp. Coffee Home, Laxmi Nagar, Delhi. 4. NIZAMUDDIN CENTRE : Ghalib Academy, Basti Hazrat Nizamuddin, New Delhi -110013. 5. QUIDWAI NAGAR CENTRE: R.D.S.B.V. No.1, (G.B.S.S.School,No.1), Kidwai Nagar/INA Colony, Near DDA Office, New Delhi 6. YAMUNA VIHAR CENTRE: G.B.Sr.Sec. School, B Block, Yamuna Vihar (Directorate of Edn., Distt. East) 7. MAYUR VIHAR CENTRE: Shaheed Rajguru Girls College, Vasundhra Enclave, Mayur Vihar Phase 3, Delhi NOTE: Interview will be held on __________________________________AT 10.00 A.M. in Office of Urdu Academy, CPO Building, Kashmere Gate, Delhi - 110006. Passport size Photo