Application Form for Registration
Electronics & ICT Academy, IIT Roorkee
Email address
Basic IoT applications
25th sept to 29th sept 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
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.
Please complete the captcha before submitting the form.
Submit
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