THE INDIAN LAW INSTITUTE
(Deemed University)
Bhagwan Das Road, New Delhi-110001
Website: www.ili.ac.in Email: [email protected]
E-learning initiative
Application Form for online Certificate Course in
‘CYBER LAWS’
1. Candidate’s Name (in Block Letters)………………………….………………………………………..
2. Father’s/Husband’s Name ………………………………………………………………………….…..
3. Age ……..…… Years ……/…..…/……….….. (DD/MM/YYYY) Sex …..…… Category ..…….
4. Postal address ……………………………………………………………………………………………
……………………………………………………………………………………………………………
5. Tel.(Res.)…………………….(mobile)………………………E-mail………………………………….
6. Please specify Mode of Payment: [Online Payment/ Demand Draft] ___________________
If payment made through Online Payment Gateway* :
Transaction ID _________________________ Date of Transaction _________________ for Rs.7500/-
(Rupees Seven Thousand Five Hundred Only)
(*Please email copy of Payment Response page along with Application Form)
If payment made through Demand Draft
Demand Draft No. ……………….. dated …………. Bank ……………………………… for Rs.7500/-
(Rupees Seven Thousand Five Hundred Only) in favour of ‘The Indian Law Institute’ payable at New
Delhi
7. Occupation…………………………………………………………………………………………………
8. Designation…………………….…………………………………………………………………………..
9. Full name and address of office………………………………………………………………………..
… …………………………………………………………………………………………………….……
Tel.…………………..Fax No………………….. E-mail…………………………………………………
10. Details of examinations passed commencing matriculation
Examination Board/University Institution Year Division Marks (%) Subjects
11. If admitted, I undertake to abide by all the rules and regulations of the Institute, issued from time to time.
Date ……………………. Name & Signature of the Applicant
Place…………………….
Instructions for filling the Application Form:
1. The Application Form can be downloaded from the ILI’s web site (www.ili.ac.in).
2. If payment of Rs.7500/- is made through Online Payment Gateway, send Application Form along with copy of Payment Response
page duly generated by system after successful transaction through email only at
[email protected].
3. If payment is made through Demand Draft, and send hard copy of the duly filled Application Form along with a draft of Rs.7500/-
drawn in favour of ‘Indian Law Institute’ payable at New Delhi to the Registrar, Indian Law Institute, Bhagwan Das Road, New
Delhi-110001.