Online Form

Home Online Form

    Scarf Logo

    DIPLOMA IN MENTAL HEALTH CARE AND COUNSELLING
    Instruction to the candidates
    • Candidate should submit the application form duly filled in along with all documents
      required, and send it to the following address.
      Course Co-ordinator, Schizophrenia Research Foundation, R/7A, North Main Road,
      Anna nagar west extension,Chennai-600 101.
    • Fee once paid will not be refunded under any circumstances.
    1 Name of the Applicant In Block Letters* Upload Your Photo:

    (.jpg, .jpeg, .png files with minimum size of 1.5mb.)
    2 Father’s/Husband’s Name*
    3 Date of Birth*
    4 Age*
    5 Sex MaleFemaleOthers
    6 Nationality
    7 Languages Known
    8 Permanent Address*
    9 Address For Communication*
    10 Phone no/Mobile no*
    11 Email id*
    ACADEMIC RECORD
    12 Exam Passed Subject(s) Year of Passing Institution studied Class % of Marks
    13 Are you currently employed? YesNo
    14 If YES, Current Occupation details
    15 To attach documents*
    (For uploading multiple files, convert the files into .zip format with minimum size of 1.5mb.)

    I hereby assure that the information provided here are true.

    Enclosures:
    1.Self attested copy of the degree certificates.
    2. If Employed, No objection certificate from the employer (NOC)

    Note: PDF version of the filled in application form will be sent to your email id.

    Top