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BHABHA Group Of Institution

Registration Form for Session 2017-18

Passport Size
Colour Photo

INSTRUCTIONS

1. Fill the form completely & carefully with providing your recent color photograph (Passport Size).
2. Take a print-out of the form after submitting.
3. Put your signature in respective columns.

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Mode Of Admission:Select one Mode only.               
Sitting Year:Year you appeared in exam Roll No.:Your roll no. in exam
Course Applied For:Select one Course only.               
Sub-Course (B.Tech.):Select one Sub-Course only.
Year of Admission:Select one Year only.     
Personal Details:Provide your Personal details.
Name of the Student:  Mr./Ms.
Mr.   Ms.
    Rs.
Date Of Birth (DD/MM/YYYY):   / /
Category:            
Address (Communication):
      Pin:
Contact No.:  Mobile:  +91 -  Land Line (if any):
Email address:
Academic Details:Provide your Qualification details.
Examination Name of School Place of
School
Passed/Appearing Year of
Passed/Appearing
Division% Marks of
PCM/PCB
Aggregate
% Marks
High School (X)
Intermediate (XII)
Post Graduation
B.Tech
College Preference:Select one Preference only.
Date:   Name:   Place:
Security Code:Provide the disaplayed security code (Click the code to re-generate).

DECLARATION

By submitting this form you are declaring that the information submitted by you is correct to the best of your knowledge.

You are not at present registered as an External, Internal, Occasional or Associate student at BGI.

By submitting this form you are agreeing to the BGI processing personal data on this form or other data which the BGI may obtain from you or other people or organisations whilst you are applying for admission. You agree to the processing of such data for any purpose connected with your studies or for any other legitimate purpose.

After you click the below "Submit Form" button, the form will be sent to a confirmation page where you have to confirm the details filled by you before register. On confirmation page, you have to click the "Confirm & Continue"
Confirm Registration details