Application Form for Registration
Electronics & ICT Academy, IIT Roorkee
Email address *
Internet of Things (IoT) technology and it's implementation with cloud
05th June to 09th June 2018
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 (MM/DD/YYYY) *
MM
/
DD
/
YYYY
Name & Address of the Organization/Institute
Organization/Institute/College Name *
Address *
City *
District *
State/UT *
Qualification *
Branch *
Required
Designation *
Required
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 *
Required
Scan copy of payment receipt *
Required
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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