DIPC 2025 Registration

Application for "Diploma in Infection Prevention and Control (DIPC) 2025"

Pay Rs. 300 Distance education course fee/registration fee before filling out this form mentioning 'the name of the course' DIPC2025. Payment Link: https://www.onlinesbi.sbi/sbicollect/icollecthome.htm?corpID=8920 Type "Online Registration" when asked application no. during payment. Keep ready scan copy of your graduation and birth (SSC/Matriculation) certificate before filling out this form. See more at www.pgdipc.com DUPLICATE SUBMISSION IS NOT ALLOWED.
Email - 1*

Confirmation EmailRetype the same email ID again
Name*

First NameLast Name (same as the SSC / Matriculation certificate in Capital Letter)
SBI Collect E_cheque Number
for Rs 300 Registration Fee payment Link https://www.onlinesbi.sbi/sbicollect/icollecthome.htm?corpID=8920. Foreign nationals can apply without this fee at the time of registration. They will be required to pay upon selection along with Term-1 Fee.
Date of Payment (for Indian nationals only)

DayMonthYear
Upload Payment Receipt

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Category
Choose from drop-down menu
Religion
Gender*

MaleFemaleOther
Aadhar No.
For Indian Residents only.
Salutation*
Blood Group
Photo*

Upload pp size close up picture or take close up photo using camera
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Father's Name*
Mother's Name*
Permanent Address*

House No. / Apartments / Street / village Address

Address Line 2

CityState

PIN CodeCountry
Correspondence Address*

House No. / Apartments / Street / village Address

Address Line 2

CityState

PIN CodeCountry
Mobile No.*
Mobile No. 2
Secondary Email - 2
example@example.com
Marrital Status*

SingleMarriedDivorced
Name of Spouse, if married

First NameLast Name
Job Status*

Un-employedEmployed Public SectorEmployed Private SectorSelf-employed
Approx. Annual Income
Are you Differently Challenged (PC)?*

NoYes
Date of Birth*

DayMonthYear
Upload SSC / Matriculation Certificate for Proof of Date of Birth *

proof of Date of Birth
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Nationality*

IndianNRI (Non Resident Indian)SAARC CountriesAfrican CountriesOther
Academic Records

Particulars of past academic records from Bachelor's Degree onwards.
Minimum eligibility qualifying criteria*

Graduate in MedicineGraduate in NursingGraduate in Allied Healthcare ScienceAny other graduate with minimum 2 years of healthcare experienceOther
Examination- 1 (undergraduate study)*
University / College
Month & Year of Passing
Subject Studied and Passed
Maximum Marks
Marks Obtained
Percentage
Division
Upload scan copy of the graduation degree certificate*

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Add Qualifications...
Examination- 2 (Postgraduate study)
University / College
Month & Year of Passing
Subject Studied and Passed
Maximum Marks
Marks Obtained
Percentage
Division
Upload scan copy of the post graduate certificate, if applicable

Ignore, if not applicable
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Add Qualification.....
Examination- 3 (Postgraduate study (ii) if applicable)
University / College
Month & Year of Passing
Subject Studied and Passed
Maximum Marks
Marks Obtained
Percentage
Division
Scan copy of the certificate - 3, if applicable

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Current Designation and Nature of Job
Organaisation / Institution
No. of completed years worked in healthcare
From (Month & Year)
To (Month & Year)
Till date if not working currently

Other Experiences....
Past Work Experiences

Give detail latest in the top
Designation and Nature of Job done - 2
Organaisation / Institution worked-2
No. of years worked
From (Month & Year)
To (Month & Year)
Designation and Nature of Job done - 3
Organaisation / Institution worked-3
No. of years worked
From (Month & Year)
To (Month & Year)
Upload Experience Certificate, (Not required for graduate in medicine, nursing and allied healthcare).

Graduates in other than medicine, nursing and allied healthcare disciplines, require a minimum of 2 years of healthcare sector experience and must submit the work experience certificate.
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Application Submission
Declaration by the applicant*

I hereby declare that all the information furnished by me in this application and the ducuments I have submitted in support of my application are true, complete and correct to the best of my knowlege and belief.
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Application for "Diploma in Infection Prevention and Control (DIPC) 2025"

Academic Records

Past Work Experiences