MIMIT, MALOUT Registration Form Admissions 2017-18
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Name of Applicant as per Matriculation Certificate *
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Father's Name
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Mother's Name
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Date Of Birth
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Sex
E-Mail Address
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Category
Complete Address For Correspondence:
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State of Residence/Domicile *
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City
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Mobile Number (Parents)
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Mobile Number (Self) *
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Educational Qualification
Exam Passed
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Board/School
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Year of Passing
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Percentage of Marks
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JEE Rank/Marks
(Only for B. Tech Courses)
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Hostel Required
How did you came to know about the Institute? *
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