SPECIALIZED REFRESHER MODULES IN CLINICAL NUTRITION AND DIETETICS Indian Dietetic Association is pleased to offer the second set of the Specialized Refresher Modules in Clinical Nutrition and Dietetics from April 2015. The course is through distant learning mode. Course Co-ordinators Ms Rekha Sharma - President, Indian Dietetic Association (2011-2014) Dr Veenu Seth -Member, RD Board, IDA Ms Ritika Samaddar -Executive Member, Delhi Chapter IDA Ms Anuja Agarwala -National Executive Member, IDA The four modules being offered are: 1. Assessment of Nutritional Status 2. Medical Nutrition Therapy in Diabetes mellitus 3. Weight Management 4. Pediatric Nutrition Some Aspects Faculty Ms Rekha Sharma, M.Sc., RD; Director, Nutrition and Dietetics, Diabetes Foundation (India),Country representative and Director, International Confederation of Dietetic Associations, Former Chief Dietician, All India Institute of Medical Sciences, New Delhi Dr Veenu Seth, M.Sc., Ph. D. Nutrition, RD; Nutrition Consultant and Former Associate Professor, Nutrition, Lady Irwin College (Delhi University), New Delhi; Clinical Director (Health Promotion) Special Olympics International Ms ManjuMathur, M.Sc., RD;Clinical Nutritionist and Former Chief Dietician &Head,Department of Dietetics, Government Medical College & Hospital, Chandigarh Ms AnujaAgarwala,M.Sc., RD; Dietitian,Department of Pediatrics, All India Institute of Medical Sciences, New Delhi Ms Meenakshi Bajaj, B.Sc.,PGDND,M.Sc.,RD,CDE; Dietician,RGGGH&Coordinator, Academy of Clinical Nutrition, MadrasMedicalCollege, Chennai
Ms Madhu Sharma, M.Sc.; Independent Diet Consultant "Diet for life", Panchkula, Former PediatricDietitian, PGI, Chandigarh Dr PriyankaRohatgi, M.Sc., Ph.D. ADND, PGCCGM (XLRI); Chief Clinical Nutritionist, HOD, Department of Nutrition and Dietetics, Apollo Hospitals, Bangalore Ms Namrata Singh, M.Sc., RD; Dietician, Department of Human Nutrition and Gastroenterology, All India Institute of Medical Sciences, New Delhi Eligibility Conditions Members of IDA with a post graduate degree/diploma in Food, Nutrition and Dietetics shall be eligible. The applicants may opt for one or more modules of their interest at one time. Candidates are required to fill a separate application form for each module.last date for receiving the completed application forms for the course commencing from April, 2015 is 15 th March, 2015. Duration of modules shall vary from 10to12 weeks, depending upon the course. This shall be followed by a two three day contact programme for every module, towards the end of the stipulated period.the contact programme shall be conducted in an education hub, presently at Delhi. Final evaluation of the candidates shall be done after the contact programme. Candidates securing a minimum of 70% marks shall be considered successful and shall be awarded a certificate by IDA. Fee Structure: Rs 3000 per module. Venue of contact programme shall be Indian Dietetic Association, Plot number 3, Pocket B11, VasantKunj, New Delhi 10070. Contact mail ID for queries:idacourse@gmail.com.
Application Form Course Enrolment No. (For Official Use) INDIAN DIETETIC ASSOCIATION EDUCATION AND RESEARCH CENTRE Specialized Refresher Modules in Clinical Nutrition and Dietetics (Distant Learning Mode) APPLICATION FORM Submission of completed Form before March 15 th,2015 Affix a signed passport size photo here Tick the module for which this application is being submitted 1. A ssessment of Nutritional Status 2. Medical Nutrition Therapy in Diabetes mellitus 3. Weight Management 4. Paediatric Nutrition - some aspects A separate application is required for each module Please type or use block letters to write your full name. Female Male / / (Mr/ Mrs/ Ms/ Dr) (First name) (Family name) Date of Birth: / / ( Day) (Month) (Year) IDA life membership number National Number Present Address for Correspondence: State Pin Home telephone: Mobile number: Email address: Current position/job title (if applicable): 1of 2
EDUCATIONAL QUALIFICATIONS S.No. Certificate / Diploma / Degree 1 School Leaving (class XI1) Year of Passing Institution, City& Country Major Subjects / Area of Specialization 2 B.Sc. 3 PG Diploma 4 M.Sc. 5 Ph.D. 6 Any Other (specify) REFERENCES:Name one refereein support of your application. Name: Designation & Institution: Contact Address Phone No.: Send the completed application form with necessary enclosures to the following address by 15 th March, 2015: INDIAN DIETETIC ASSOCIATION, PLOT NO.3,POCKET B11, VASANT KUNJ NEW DELHI- 110070. DETAILS OF THE BANK DEMAND DRAFT (Fee per module: Rs Three Thousand only /(Rs 3000/-) Demand Draft No. Dated Amount (Rs) Payable to: Payable at: INDIAN DIETETIC ASSOCIATION - ERC STATE BANK OF INDIA ANSARI NAGAR BRANCH NEW DELHI-110029 Date: / / (Day) (Month) (Year) Place: Signature of the Applicant
Suggest other areas of interest in Clinical Nutrition& Dietetics in which you would like such courses: -Renal - GI tract & accessory organs - Paediatrics - Geriatrics - Women s health - Cancer - Critical care - Any other (specify) SPECIAL INSTRUCTIONS (1) You will receive your (a)enrolment No. (b) Contact Program Entry Slip and (c) Module, once your documentation is complete and payment is received. (2) You must carry your Contact Program Entry Slip when you come to attend the Contact Program (3) Mandatory Enclosures : - Application form with complete information - Self attested photocopy of valid ID-card or IDA National Certificate - Self attested photocopies of mark sheets + degrees and/ordiploma - Proof of present employment, if applicable - Course fee Demand Draft payable at SBI, Ansari Nagar Branch,New Delhi 110029 in favour of Indian Dietetic Association - ERC - Two signed Passport size photographs one to be affixed in the application form and the other to be affixed on the detachable contact program slip to be used as an entry card for the contact program. For Official Use Only Receipt No. Date Enclosures: Complete/ incomplete Admission: Yes/ No For Course 1/2/3/4 Course Enrolment No. Signature of the course co-ordinator
CONTACT PROGRAM ENTRY SLIP Name of the candidate: Course Enrolment No. Module Name and Code Date of Contact Program Affix a signed passport size Photo here 1of 2