Registration-Form

News & Events


Walk-in-Interviews for Faculty Positions On Sunday, 17th July, 2011 at 11:00 AM Click Here

Walk-in-Interviews for Faculty Positions
On Sunday, 17th July, 2011 at 11:00 AM
Click Here

	Buddha Institute of Technology

		CL-1, Sector-7, GIDA, BADGHAN
		Gorakhpur-273209 (U.P.) - Phone: 0551-2580413, 2580414, 2580415

	S.No.1498567			Date:2/22/2012
	* Marks Are Mandatory Field.

(A)	REGISTRATION DETAILS:-
1.	Course Details*	1st Preference*	2nd Preference*	3rd Preference*


2.	UPSEE Rank	Roll No.	AIEEE Rank	Roll No




(B)	PERSONAL DETAILS

1.	Name of the Applicant Mr./Ms.
	First Name*	Middle Name	Last Name*


2.	Date Of Birth	Day*	Month*	Year*


3.	Sex*	Category*	State Of Domicile*
	MaleFemale

4.	Correspondence Postal Address(IN CAPITAL)(Do Not Repeat Name)*


	Pin Code

5.	Telephone No.

	Mobile

	E-Mail*

6.	Father's/Husband's Name*

7.	Father's Profession

8.	Do You Need Hostel Accommodation?*		YesNo

9.	Do You Need Transportation Facility?*		YesNo


(C)	Academic Details:-

	Exam	Board/University*	Marks %*	PCM %*	Year Of Passing*
	10+2

	10th



(D)	Where Did You Learn About BIT?
		News Paper Radio T.V. Friends Others


(E)	Declaration: I hereby declare that the information given by me in the registration form is complete and accurate. I understand and agree that misrepresentation or omission of facts will lead to cancellation of my admission or expulsion, at any stage. I agree to abide by the rules and regulations of Buddha Institute Of Technology, existing / to be framed later on. The decision of the Director shall be final and binding on me. I hold myself fully responsible for prompt payment of fees and any dues, if selected. I have noted that fees once paid are not refundable, under any circumstances. I will not indulge in any form of ragging and if found indulging can be expelled immediately.
		AcceptDecline *