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Registration Form: Space For Photograph

The registration form collects personal details of the candidate such as name, date of birth, guardian information, address, contact details, education history including boards and percentages, branch preferences for B.Tech, details of competitive exams appeared in, and whether hostel and transport facilities will be required. Submission of the completed registration form does not guarantee admission to any of the programs offered at IILM Greater Noida.

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Vikas Gupta
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37 views

Registration Form: Space For Photograph

The registration form collects personal details of the candidate such as name, date of birth, guardian information, address, contact details, education history including boards and percentages, branch preferences for B.Tech, details of competitive exams appeared in, and whether hostel and transport facilities will be required. Submission of the completed registration form does not guarantee admission to any of the programs offered at IILM Greater Noida.

Uploaded by

Vikas Gupta
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Space for

Photograph
18, Knowledge Park-II, Greater Noida-201306 (UP)
Ph No : 0120-6002159/ 62/ 63/ 65, 8860427532 / 8860427537 Fax:0120-2320058
Website : www.iilm.ac.in/gnoida, Email: [email protected]

Registration Form
Course Applied for: B.Tech / M.Tech (BT/ME/EEE) / MBA/ MAM
Branch Preference: (Applicable for B.Tech only)

Biotechnology
Computer Science & Engineering
Electronic & Communication Engineering
Electrical & Electronic Engineering
Mechanical Engineering
Automobile Engineering
1. Name of Candidate: ________________________________________________________________________
2. Date of Birth: ____________________________________________
3. Guardians Name & Relationship: _____________________________________________________________
4. Address for Correspondence:_________________________________________________________________
_________________________________________________________________________________________
5. Mobile No: _____________________________

Alt Mobile No: _________________________________

6. Email Id: _______________________________


7. Details of Qualifying Examination:
S. NO.

Examination Passed

1.

10th

2.

12th

3.

Graduation

Roll No.

Board/University

Year of Passing

%age of Marks

Major Subjects

8. Aggregate Marks in PCM /PCB(for B Tech only):


9. Details of Competitive Exam appeared in:
Examination

Year

10. Hostel required:

YES / NO

11. Transport required:

YES / NO

(Signature of Candidate)

Roll No

Rank

Remarks

(Signature of Parent / Guardian)

SUBMISSION / ACCEPTANCE OF REGISTRATION FORM DOES NOT GUARANTEE ADMISSION

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