Application form for UG Courses, Dr.B.Lal Institute of Biotechnology

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Course Details
Personal
Parent Details
Education 1
Education 2
Others
Declaration
Documents

Course Details

Course Applied for *

Personal

Your Name *

Email *

Date of Birth *

Place of Birth *

Gender *

Category *

Nationality *

Mobile Number *

Phone No

Permanent Address *

City (Permanent) *

PIN Code (Permanent)

Country (Permanent) *

State (Permanent) *

Parent Details

Parent's / Guardian's Name *

Parent's / Guardian's Relationship with Candidate *

Parent's / Guardian's Profession *

Parent's / Guardian's Annual Income (INR/Rs.)

Address for Correspondence on Admission Matters *

City *

PIN Code

Country *

State *

Education 1

Class 10th Board Name *

Class 10th School Name *

Class 10th Major Subjects *

Class 10th Year of Passing *

Class 10th Marks (in %) *

Education 2

Class 12th Board Name *

Class 12th School Name *

Class 12th Major Subjects *

Class 12th Year of Passing *

Class 12th Marks (in %)

Please specify if there has been any discontinuity in your educational record and mention the activities undertaken during that period.

Others

Mention your Interests/Extracurricular activities

Explain your reason for choosing this course ?

Languages you can Read

Languages you can Write

Languages you can Speak

Declaration

I declare that all statements made in this application are true to the best of my knowledge and that the marks submitted by me in this application form pertain only to examinations conducted by a Board/University and passed by me after undergoing studies as a regular student of a recognized institute. I understand that if any statement is found wrong, my admission to the institute will stand cancelled.

I agree to the terms and conditions mentioned in Prospectus and I promise to abide by the rules and regulations in force or those that may hereafter be made for the administration of the institute and I shall do nothing either inside or outside the institute which interferes with orderly working and discipline. In all matters concerning me and the institute, the decision of the Principal shall be binding on me.

* Yes