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EDI Registration

The registration will be made on First Come First serve basis. Register yourself by 29.01.2013, 9.30 am.

UNDERTAKEN:

By submitting this form I am agree to the rules regulations of Academic tour committee. I will follow it without fail. I will maintain discipline during the visit. I undertake this journey at my own risk.

Enrollment No *
Example - 201204100710XXX
Full Name of Student *
Name then Father's Name then Surname
Student Mobile No *
Example - 09876543210
Course *
Example - MBA / MAM
Semester *
Select Semester
• Semester 1
• Semester 2
• Semester 3
• Semester 4
Date of Birth *
Example - 14 February 1985
Gender *
Select
• Male
• Female
City (Permanent Residence) *
Permanent city name (As per your permanent address)
City (Current city from where you are commuting) *
It can be either College Hostel, Bardoli (For PG), or other current city
Place from where you will join the tour. *
Select any one place as per your choice.
• College
• Bardoli
• Kadodara
• Surat
• Kamrej / Kim
Parent's Name *
Name + Father's Name+ Surname
Parent's Contact No *
09876543210

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