Directorate of Open and Distance Learning : : Dibrugarh University : : Dibrugarh.



                                                                        (To be filled up by the Institutions applying for permission as a study Centre of DODL, D.U.)

  1.  (a) Name of the Institution :

              (b) Full Address of the Institution :

  1. The Head of the Institution :
  •   Name :
  •   Designation :
  •  Telephone No. : Office :

               Mobile :

  •  Fax No. :
  1. Is your Institution affiliated to University / Council / Board ? : Yes / No. If Yes, mention University / Council / Board to which it is affiliated. (Please enclose documents) :
  2. Is the Institution a Registered Society ? : Yes / No.

          If Yes, please state :

           Registration No. :

            Date :

           (Please enclose Xerox copy of the Registration Certificate)

  1. Is the Institution a Registered Trust ? : Yes / No.

             If yes, please give details :

             ( Please enclose Xerox copy of the Registration document)

  1. Briefly describe the activities of your :

              Institution (Enclose the Annual Report)

  1. Resolution of the Governing Body / : Board of Management regarding opening of the DODL Study Centre under Dibrugarh University. 8. Subject (s) proposed to be : introduced under the DODL of D.U. 9. Give the subject wise lists of teachers : with their names, qualifications, specialization and teaching experience (Enclose written letter of consent from the willing teachers)
  2. Do you propose to induct Visiting Faculty ? : Yes / No. If yes, state
  • of faculty :
  • Give their names, qualification, :

            Specialization, Experience etc. (Enclose written letter of willingnesss from the proposed visiting faculty)

  1. Does your Institutions has its own Buildings ? Yes / No.

             If Yes, (Enclose relevant documents)

             If NO, (Enclose the copy of the agreement with the Landlord whose buildings are being used on rent / lease etc.)

  1. State the no. of :

              (a) Books available in your library :

               (subject wise)  (b) Journals :

  • Computer :
  • Xerox machine :
  • Overhead Projector :
  • Any other Teaching Aids/ :

          Equipment’s available.

            (Give details)

  1. State the expected no of students : likely to get themselves admitted in each subject.
  2. Give the names of the feeder institutions : and localities from where your institution could attract students for the Distance Education Course(s).
  3. How do you visualize to run the Distance Education Programme?

           (a) Academic Counselling :

  • Duration :
  • Venue :

            (b) Give a brief note on the sources and uses : of finance in connection with Academic Counselling and Administrative support.

  1. Give five strong points of your institution for : being recognised as a Directorate of Open and Distance Learning Study Centre.
  2. Any other information relevant to your proposal • Date : Signature


     N.B. You can use a separate sheet for more information.