SATKHOL APPLICATION FORM
(Kindly note that all mandatory fields (marked with *) are to be filled in.
 
IMPORTANT: Please ensure Email IDs are spelled correctly. Incorrect email addresses will delay registration process.
 
Personal Information
Center*
Primary Contact Name*
Address Line 1*
Address Line 2
City*
State*
Postal Code*
Country*
Phone (with STD code)  
Mobile
Email ID*
Other Information
Please select batch type. Full week batches run Tuesday through Sunday, with dorms and Pearl available as accommodation options. Weeken batches run Thursday through Sunday, with Pearl the only accommodation option.
Batch Type*
Authorization from Preceptor / Centre-in-charge is essential. Please enter relevant particulars below. Please make sure Email ID is correct.
Preceptor's Name*
Preceptor's ID Number*
Preceptor's Email ID*
Applicants
Sl. No. Name* Age* ID Number* Date of Joining in DD/MM/YYYY format Male Female
1. Click Here to Select date
2. Click Here to Select date
3. Click Here to Select date
4. Click Here to Select date
5. Click Here to Select date
6. Click Here to Select date
Accommodation

Accommodation preference*:    

Processing & queries: Forms are accepted while space is available. Approval status with the allotted batch will be intimated to the preceptor and centre-in-charge.For any queries, write to satkholregistration@srcm.org.