APPLICATION FORM
POST GRADUATE DIPLOMA
IN
INTELLECTUAL PROPERTY RIGHTS AND PATENT MANAGEMENT
9-month (full-time) program (includes 3 months of Industry Internship)
FORM NO: ______(please leave blank)
INSTRUCTIONS
• Incomplete forms will not be considered
• This form is divided into Section A, B, and C.
Personal Information ...... Section A
Assessment Questions ...... Section B
Misc Course Related Information ...... Section C
• Selection to the program is at the discretion of the Institute
Please Pasteyour recent passport size photograph here (3.5 cm X 3.5 cm)
DATE OF SUBMISSION: ______
PRFERRED LOCATION:
Delhi ______, Bangalore ______(please tick)
Name: / Date of Birth:Marital Status: / Gender:
SECTION A: PERSONAL DATA
CONTACT INFORMATION
Correspondence Address:Permanent Address:
Phone: (mandatory)
Alternate Phone:
Mobile: (mandatory)
Email id:
ACADEMIC RECORD
Institution / Board/University / Year of passing / Major Subjects / Marks (% or CGPA) / Examination PassedWORK EXPERIENCE (Present Job to the First Job)
Total Work Experience, if any ______months
Organization / Designation / Start date – End date / Brief Job Description / Mention any specific experience / achievements
(please mention if any work experience in field of IP)
SECTION B: ASSESSMENT QUESTIONS
Please do not leave any question unanswered in this section.
Use Additional Sheets, if required.
1. Please describe below your special academic interest(s) and objective(s) in undertaking this program (max. 500 words)
2. Extra Curricular Activities and Interests
3. Academic Achievements
4. Non Academic Achievements
5. Do you have any research experience? If yes, please describe in detail. Also list your publications in domestic and international journals, if any.
6. Write a short paragraph not exceeding 200 words, on any two topics out of the following:
a) China and India are the world’s next major powers – Can India Overtake China?
b) IP is the foundation of knowledge-based economy
c) Attitude – It changes everything
d) Plagiarism/Breach of copyrights in modern age
e) Entrepreneurs protect ideas. How?
f) Influence of Politics in India on the Youth
g) India has one of the largest pools of talented manpower, but few innovations and patented products.
How did you come to know about the program? (Please tick)
Please specify the name of the Newspaper/Journals etc.Newspaper Advertisement
Journals/Magazines/Newspaper Articles
Online Search
Mailer From GIIP
Friends
Others (Please Specify)
SECTION C: MISC. COURSE RELATED INFORMATION
DO YOU WISH TO SEEK EDUCATION LOAN: (write ‘YES’ or ‘NO’ in the text box below)
(If the answer is YES, we will forward your details to the bank for eligibility assessment)
DO YOU REQUIRE ASSISTANCE IN LOCATING A SUITABLE PLACE TO STAY (PG / HOSTEL / RENTAL) FOR THE PROGRAM DURATION (write ‘YES’ or ‘NO’ in the text box below)
IMPORTANT NOTE:
The Program is GIIP’s independent professional skill development program, aimed at providing hands-on and practical training in field of International Patents and Intellectual Property services. This program is not covered under AICTE. In case of any dispute, it would have to be got resolved through arbitration under Arbitration and Conciliation Act 1996 by the sole arbitrator appointed by Global Institute of Intellectual Property at New Delhi. Fee once deposited is neither refundable nor adjustable under any circumstances.
DECLARATION BY THE CANDIDATE APPLYING FOR THE PROGRAM
I hereby declare that I have read and understood the conditions of eligibility for the program. I fulfil the minimum eligibility criteria and I have provided necessary information in this regard. In the event of any information being found incorrect or misleading, my candidature shall be liable to cancellation by the Institute at any time and I shall not be entitled to refund of any fee paid by me to the Institute.
Name of the candidate Place
Date Signature
ELCINA House, 422 Okhla Industrial Estate, Phase III, New Delhi – 110020 (INDIA)
Phone: +91-11-41084800, 41084900; Email id:
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