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Wednesday, 01 September 2010 05:30

Download Form for Press Card

Download forms for state: Delhi
Form Details
DepartmentDepartment of information and public relations
TitleForm for Press Card
Document Size22.5 KB
Text of the PDF document(for quick reference)
Directorate of Information and Publicity Government of NCT of Delhi Block no 9, Old Sectt Delhi-110054 Form for Press Card (APPLICATION FORM (IN TRIPLICATE) TO BE FILLED IN BY THE APPLICANT ACCOMPANIED WITH 3 COPIES OF PASSPORT SIZE PHOTOGRAPHS SHOULD BE FORWARDED BY THE EDITOR OF THE PAPER CONCERNED.) 1. Name in full (In capital letters) 2. a)Designation _____________________________________________________ b)Nature of Employment: 3. Father's/Husband's name _________________________________________ 4. Qualifications _________________________________________ 5. Date of birth _________________________________________ 6. Blood group __________________________________________ 7. Nationality ________________________________________ 8. Present residential address _________________________________________ Full time Part time Contractual Others Telephone(R)______________Mobile_______________________ 9. Address during last 3 years _________________________________________ (if different from col.8) 10. Name & address of __________________________________________ the Organisation in which working Telephone(O)_______________E-mail Address_____________________ 11.Language and periodicity of the Publication/ Language of the Channel _________________________________________ 12.Current Circulation (for print media) __________________________________________ 13.Current Sales Turn over of the company (for Electronic media) ___________________________________________ 14.Whether accredited with PIB (Govt of India)/ Yes/No other state Government .If yes, give PIB No. ___________________________________________ 15.Journalistic experience for last 3 years with details________________________________________ (Enclose copy of the certificates for proof) 16.Reference of two citizens of your locality: Sl.no. Name Occupation Address Tel.No. 17.Recommendations of two journalists accredited with Government of NCT of Delhi with particulars as below: Sl.No Name Designation Name of the Particulars of Press Signature . Publication/ Card channel Card No. Valid Upto Declaration: I hereby certify that the above information is correct and complete to the best of my knowledge and belief. Signatures of the applicant Checklist of documents attached:-YES NO 1.Forwarding letter from the Editor recommending the case. 2.Four stamp size photographs. 3.Copy of the appointment letter. 4.Copies of the 3 years experience certificate. 5.Copy of the current circulation(RNI/DAVP)/sales turn over certificate. 6.Copies of last One year's issue of publication.
Last Updated on Friday, 17 December 2010 05:30

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