Page 40 - VGSoM MDP Brochure

38 MDP@VGSOM 2019-2020 MDP@VGSOM 2019-2020 39

NOMINATION FORM
Application and Payment Process

Title of the Programme
The candidates can apply for chosen events by clicking APPLY NOW against the available programs at
https://erp.iitkgp.ac.in/CEP/secure/courses.htm.
Duration of the Programme
The programme fee is payable online by clicking on the Fee Payment option after login at
https://erp.iitkgp.ac.in/CEP/secure/courses.htm.
All payments should be made to CEP-STC, IIT Kharagpur, Account No: 95562200002955, Syndicate Bank, Branch: TO BE FILLED BY THE PARTICIPANT
SRIC, IIT Kharagpur-721302, IFSC code: SYNB0009556.
Name:

Gender: Age:

Designation:

Organisation:

Mobile:

Email:

TO BE FILLED BY SPONSOR

Once paid, please send an email to Ms. E. Amruta Priyadarsani, Project Executive, Name of the Sponsor:
MDP Programmes with a copy to the respective Programme Coordinator(s).

Ms. E. Amruta Priyadarsani Address for
Project Executive Communication:
MDP Office, VGSoM, IIT Kharagpur
Email : mdp@vgsom.iitkgp.ac.in
Phone : 03222-82313 (O) IIT Khargapur PAN IIT Kharagpur is exempted from Income tax as per Income tax act Section
Mobile : +91 9932623194 AAAJI0323G 10(23C)(iiiab). Tax Exemption certificate will be issued, if required.

Candidate's Signature/ Nominating Authority's Signature