Scholaship Registration Form

Your Name *

Mobile No. *

Already exist the number..

E-mail

Your Father's Name *

Mobile No. *

E-mail

Your Mother's Name *

Mobile No. *

E-mail

Country of Origin*

Complete Present Address *

Complete Permanent Address *

Your first choice for higher education at IUBAT under this Scholarship *

Your second choice for higher education at IUBAT under this Scholarship *

Provide contact particulars of three classmate referees (who were classmates at 12th Grade of Education and are willing to tell good things about you)

a) Name: *

Cell: *

E-mail:

College / Institution: *

b) Name: *

c) Name: *

Contact particulars Principal / Director of your college / Institute

Name: *

Cell: *

E-mail:

College/Institute: *

Your academic qualification: *

Examination:
Secondary (10th Grade)

Group:

GPA/Result:

Passing Year

Higher Secondary (12th Grade) Diploma

Group:

GPA:

Passing Year

* Upload (pp size) photo:

* Upload Secondary Certificate:

* Upload Higher Secondary Certificate: