Application Form – DFI

Skip to content

Linkedin Facebook Twitter Youtube

12th Ahuja Bajaj Symposium – 3rd and 4th August 2024, at The Grand New Delhi. Click Here To Register

Linkedin Facebook Twitter Youtube

dfilogo

Home
About Us
Projects
Research
Education and Awareness
Training Programs
Work With Us
- Why Work With Us
- Current Openings
Recent Highlights
- News Articles & Publications
- Media & News
Contact Us

blank-image

blank-image

blank-image

project-and-services-Quiz Competition

projects--Poster Making Competition

projects-School Lecture

projects-World Diabetes Day Walk

Health camp img 1

IMG_20210811_113138

IMG_20210824_135932

Application Form

SPECIAL INSTRUCTIONS (How to apply)
(1) Upload self attested passport size photograph (max. upto 1 MB)
(2) Enclosures / Upload:
– Self attested photocopies of mark sheets + degree and/ or diploma
– Course fee – Screenshot of the online payment (See below bank details)
– Proof of present employment, if applicable

You will receive your (a) Enrolment No. (b) Module, once your documentation is complete and payment is received.

Last date to fill the form is: April 01, 2023

Application Form

Upload your signed passport size photograph here

Click or drag a file to this area to upload.

Tick the module for which this application is being submitted *

1. Assessment of Nutrition status
2. Medical Nutrition Therapy in Diabetes mellitus
3. Weight Management
4. Immune Enhancing & Health Promoting Dietary constituents
5. Latest nutrition trends: Keto diets, Intermittent Fasting (IF) etc

A separate application is required for each module (Fees per module: INR 4,500/-)

Please type or use block letters to write your full name. *

First

Middle

Last

Select Gender *

Male
Female

Date of Birth:

Present Address for correspondence:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home telephone:

Mobile number:

Email address: *

Current position / job title (if applicable)

EDUCATIONAL QUALIFICATIONS

Layout

Certificate / Diploma / Degree
1. School Leaving (Class XI)

Year of Passing, Name of Institution & Board

Major Subjects/Area of Specialization

Upload

Layout (copy)

2. B.S.C

Year of Passing, Name of Institution & Board

Major Subjects/Area of Specialization

Upload

Layout (copy) (copy)

3. PG Diploma

Year of Passing, Name of Institution & Board

Major Subjects/Area of Specialization

Upload

Layout (copy) (copy) (copy)

4. M.S.C

Year of Passing, Name of Institution & Board

Major Subjects/Area of Specialization

Upload

Layout (copy) (copy) (copy) (copy)

5. Ph.D.

Year of Passing, Name of Institution & Board

Major Subjects/Area of Specialization

Upload

Layout (copy) (copy) (copy) (copy) (copy)

6. Any other (Specify)

Year of Passing, Name of Institution & Board

Major Subjects/Area of Specialization

Upload

REFERENCES: Name one reference in support of your application.

Name:

Designation & Institution:

Contact Address

Phone No:

Bank name: Yes bank
Bank account no: 028394600000054
IFSC Code: YESB0000055

Upload (Online Payment Screenshot)

Click or drag a file to this area to upload.

Place:

Upload (Signature of the Applicant)

Click or drag a file to this area to upload.

Affix a signed Passport size photo here

1. Assessment of Nutrition status

2. Medical Nutrition Therapy in Diabetes mellitus

3. Weight Management

4. Immune Enhancing & Health Promoting Dietary constituents

5. Latest nutrition trends: Keto diets, Intermittent Fasting (IF) etc

A separate application is required for each module

Choose Gender

Female Male

Please type or use block letters to write your full name.

(First name)

(Family name)

Date of Birth:

Present Address for correspondence:

State

PIN

Home Telephone

Mobile Number

Email Address

Current position/ job title (if applicable)

EDUCATIONAL QUALIFICATIONS

S.NO

Certificate / Diploma / Degree

Year of Passing

Institution, city & country

Major subjects/ Area of specialization

REFERENCES: Name one reference in support of your application.

Name

Designation

Contact Address

Phone No.

How to apply
Send the completed application form with necessary enclosure to the following address 15th December 2022 along with payment (Fee per module: INR 6000/-)
Diabetes foundation India (DFI)
PLOT NO.3, Pocket B11, VASANT KUNJ, New Delhi-110070

DETAILS OF THE BANK DEMAND DRAFT

Demand Draft No.

Dated:

Amount (RS)

Payable to: Diabetes Foundation India

Payable at: New Delhi

Date:

You can apply online: Attach online payment screen shot along with the form
Bank name: Yes bank
Bank account no: 028394600000054
IFSC Code: YESB0000055

Place

Signature of the Applicant

Course Enrolment No.

SPECIAL INSTRUCTIONS
(1) You will receive your (a) Enrolment No. (b) Module, once your documentation is complete and payment is received.
(2) Kindly enclose:
- Application form with complete information
- Self attested photocopies of mark sheets + degree and/ or diploma
- Proof of present employment, if applicable
- Course fee – Demand Draft payable?
- Two signed Passport size photographs – one to be affixed in the application form and the Other to be affixed on the detachable contact program slip to be used as an entry card for the contact program.
_________________________________________________________________________________________________________________________________________________________________________________

For official Use only

Receipt No.

Date

Enclosures:

Complete

Incomplete

Admission:

Select

For Course

Course Enrollment No.

Signature of the course co – Ordinator

S.NO	Certificate / Diploma / Degree	Year of Passing	Institution, city& country	Major subjects/ Area of specialization
1.	School Leaving (class XI )
2.	B.S.C
3.	PG Diploma
4.	M.S.C
5.	Ph.D.
6.	Any other (Specify)

Copyright © 2024 DFI | Developed by [NetBin Technologies]

Linkedin Facebook Twitter Youtube

Quick Link

Home
About Us
Research
Training Programs

Resource

Why Work With US
Named in AIIMS Alumni
Contact Us

Contact Info

Diabetes Foundation India, Plot no. 3 Pocket B-11 Vasant Kunj New Delhi 110070
011 41345550
ndocfoundation@gmail.com