Application Form for Registration
Electronics & ICT Academy, IIT Roorkee
Email address *
Artificial Intelligence
18th Dec to 23rd Dec 2017
Note
Draft will be made in the name of "DEAN SRIC IIT ROORKEE"
Name of the Applicant *
Gender *
Required
Father's Name *
Category
Date of Birth (DD/MM/YYYY) *
MM
/
DD
/
YYYY
Name & Address of the Organization/Institute/College *
Qualification *
Branch *
Designation *
Mobile Number *
Do You Need Accomodation *
Required
Demand Draft/RTGS/NEFT Details
Amount
Demand Draft/RTGS/NEFT Number
Payment Date
MM
/
DD
/
YYYY
Name of The Bank
Applicant Photograph
Scan copy of payment receipt
Note
1. The Demand Draft with application form must reach to the following address: Mr. Prateek Sharma, EICT Academy, ECE Department, IIT Roorkee, Uttarakhand 247667.
A copy of your responses will be emailed to the address you provided.
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