Address:

The Heritage School, Sector 62, Gurgaon - 122002 (India)

T: + 91 9810236412, L: 0124-2855222

www.iamateacher.in

APPLICATION TO POST GRADUATE

DIPLOMA IN LEARNING AND TEACHING

A complete application to the PGDLT program consists of the following:

• Online Registration

• Application Form (Section 1)

• Resume / Curriculum Vitae (Section 2)

• Statement of Purpose (Section 3)

You can either submit a hard copy of all the above at our office or log on to our website to submit online.

Section 1 - Application Form

For the academic session _______

Personal Details

Full Name: Dr./ Mr./ Ms. _____________________________________________________________________________________

(First Name) (Last Name)

Date of Birth: ______________________________________________________________________________________________

Marital Status: Single / Married

Residential Address: ________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Pin Code: ____________________________ State: ____________________________ Country: ________________________

Phone Number: ____________________________ Email: ____________________________ ____________________________

Paste your recent passport size photo

PHOTO

Educational Background

Name ofExamination

Streamof Study

Year and Durationof Study

BoardUniversity

Nameof the School/

Institute

Overall Percentageor Grade

Point Average

HigherSecondary

or equivalent

Bachelor'sDegree

Do you believe your grades are a true measure of your academic ability? Why or why not?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

__________________________________________________________________________________.

Have you had any interruptions in your course of study? If yes, What were the reasons?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

__________________________________________________________________________________.

Distinctions, honors and awards, if any:

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

__________________________________________________________________________________.

Professional and Work Experience

Please begin with your most recent position and continue your list in reverse

chronological order.

Explain any interruptions, if any, in your employment.

_________________________________________________________________________________________________________

__________________________________________________________________________________.

Years of full-time employment ________________________________________________________________________________

Are you currently working in education? Yes No

Share briefly about your current Work Environment.

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

__________________________________________________________________________________.

Name of theOrganization Designation Period of Work Key Responsibilities

(Also include your professional qualifications if any)

Year andDurationof Study

Language Skills

Mention the languages you know and your level of comfort with them as fluent

or reasonable:

S. No. Languages Speak Read Write

1

2

3

4

Any other skills you have acquired or are unique to you about which you would like to share with us?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

__________________________________________________________________________________.

1

2

3

4

Mention any special information that you would like to share with us here:

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

__________________________________________________________________________________.

Declaration:

I hereby declare that the information provided by me in the application form is true to the best of my knowledge and 'I Am A Teacher'

reserves the right to counter check the information provided by me and has the discretion to take decisions regarding my enrollment

accordingly.

_______________________ ___________________ ________________________

(Place) (Date) (Applicant's Signature)

Section 2 – Resume / Curriculum Vitae

Attach your updated resume along with the application formThe length and format of your resume or C.V. are up to your discretion.

Section 3 - Statement of Purpose

The statement should be no more than 1000 words, typed and double-spaced. Your statement should represent your original thoughts

and should be written by you alone. Plagiarism from other sources will be viewed in a poor light. Please note that the admissions

committee will consider the content in its assessment of your candidacy for PGDLT.

In your statement, please discuss:

1. Your objectives for taking this programme: how will this program will help you achieve your personal and professional goals?

2. Your background: what key experiences have contributed to your commitment to work in the field of education or with

education-related issues?

3. Why have you decided to become a teacher?

4. How do your experiences as a learner influence your thinking about teaching?

Please attach a print out of your statement of purpose with the application form before submitting.

Your Interests

Share briefly about your areas of interests and any activities you engage in related to these areas. They can be education-related, but not

necessarily. You may include anything that you feel helps define what experience you bring, demonstrates your commitment to

education, and might be important/of interest to the admission committee. (You may highlight a maximum of four activities here.)