Download - BSNL - IBT TRAINING ACADEMY (BITA)

BSNLConnecting India

Faster

PHOTO(one recent passport size

colour photo of the candidate

to be affixed)

BSNL - IBT TRAINING ACADEMY (BITA)

1) Admission Fee / Course Fee payment can be made in the form of Cash/Chq (at par) / DD drawn in favour of “Outlook Communications Pvt. Ltd” payable at Hyderabad.

OR 2) The Payment can also be made through e-banking/NEFT/RTGS. the details of Bank A/C for this

purpose is given below. After making payment through e-banking/NEFT, the students shall send an email furnishing full particulars of payment on email id ([email protected]).

ADMISSION FORM

2. Admission Fee Payment Details

01. Name of the Student Mr./Ms ...............................................................................................02. Sex: Male: [ ]: Female: [ ]: 03. Date of Birth: DD [ ] MM [ ] YY [ ]04. Information about Family members:

a) Father/Husand Name : ......................................................................................................05. Address for Communication

ii) Address for Correspondence................................................................., ........................................................................................................................................., Pin ..................................................................

06. Contacts:a) Email ID: ............................................................................. b) Landline: .............................. c) Mobile : ..............................

3. Personal Information

1. Mode of Payment

Cheque / D.D. No./NEFT Date Name of the Bank & Branch Amount

Training Venue

For office use only

Roll No.:.........................................................................................................................................

Batch No. : .................................Period of Training From ...........................To.............................

NATFM, BSNL,

RTTC Campus, Gachibowli,

Hyderabad - 500 032

Connecting Success

IBTIBT INSTITUTE PVT. LTD

Sl. No.

ParticularsFee including ST where

ever applicableCheque / DD to bedrawn in favour of

Payable atDue Date for

Payment

1. Admission Fee Rs. 200/-Outlook

CommunicationsPvt. Ltd.

Hyderabad

Along with this application

2. Course Fee Rs. 6742/-To be paid on or before

commencement of Training3. Course Material Fee Rs. 1500/-

5. Schedule of Payment of Fees

6. Hostel Facility Required : Yes Not Required

7. Declaration by the Student

1. I here by declare that all the information furnished by me in the application and the documents I have submitted in support of my application are true, complete and correct to the best of my knowledge and belief.

2. We understand and here by agree that :

Ø Fees once paid will not be refunded

Ø Hostel charges for lodging and boarding are extra

Place :

Date : Signature of the Candidate

8. Submission of Filled in Application Form

Duly filled in application along with enclosures may be sent to : The DGM (Trg) & BITA Programme Co-ordinator, O/o. CGM, NATFM, BSNL, RTTC Campus, Gachibowli, Hyderabad - 500032

Graduate

Post Graduate

Ÿ

Ÿ The admission fee of Rs.200/- will be adjusted

in the course fee payment

No Refund of Fee allowed.

Bank Account No.115905000083

Name of the Bank & Branch

ICICI Bank Kalamassery, Cochi

IFSC Code.ICICI10001159

4. Academic

Qualifications:

UnderGraduate