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VOC THEOLOGICAL INSTITUTE-INDIA

A Unit of Voice Of Christ Ministries (India),

Accredited by Nations Association For Theological Accreditation(NATA)

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APPLICATION FORM

PERSONAL DETAIL

Name                       :

Address In Full         :

Date Of Birth            :

Contact No.              :

Baptism Date           :

Dipankar Basumata

Vill+Po-Marakhata, Dist-Alipurduar, Ps-Kumargram, Pin-736202, State-West Bengal

23 May 1993

9064458578

19 Dec 1993

QUALIFICATION DETAIL

Secular                    :

Graduation

Theology:

M.Div

CHURCH DETAIL

Church Name and Address:

Presbyterian Independent Church; Vill-Paschim Chengmary, Po-Marakhata, Dist-Alipurduar, Ps-Kumargram, Pin-736202, State-West Bengal

Position In Church:

Worshiper

COURSE DETAIL

Course Applied:

Medium:

English

DECLARATION

I Hereby declare that all the Information furnished in Application Form is True to the best of my Knowledge

Applicant Signature:

Date:

15 January 2023 at 10:36:17 pm

Place:

Authorized Signatory 

ADMISSION STATUS:

Confirmed

Session:

2023

Father's name

Darendra Basumata

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Registration No

041 of 2022

Sex                          :

Male

M.Th

Course Fee:

M.Th.-Rs. 3000/Sem

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Vill+Po-Marakhata, Dist-Alipurduar, Ps-Kumargram, Pin-736202, State-West Bengal

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Kongba Uchekon, PO-Singjamei-795008, Imphal, Manipur, North East India

Contact No-8258925825 , E-mail: voctiindia@gmail.com, www.voctiindia.com

All Right reserved at  VOC Theological-India 

Note This is Computer generated application form Please Print it and have a record 

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