Bioinformatics Institute of India
C-56A/28, Sector-62, Noida-201301, UP(NOIDA),
Tele:-0120 - 4320801/02,
Mob : 09818473366 ,09810535368,
e-mail: info@bioinformaticscentre.org
Project/Industrial Training in Bioinformatics


Participation No.
(For Office use only)
Paste your self attested photograph
All columns are compulsory, No column should be left blank, All in block letters
1. Participant's Name
____________ ____________
(First) (Last)
2. * Father's / Mother's Name _______________________________
3. Date of Birth
               
    (DD       MM           YYYY)
4. Sex
Male
Female
5. Address for Correspondence
_______________________________		 _______________________________________________
State _____________________ PIN ________________
  Country _________ Nationality ___________
6. Telephone numbers (Code)_________(O)_____________(R)_____________
(Mob)_____________
7. e-mail ______________________________________
8. Academic Qualifications
Exam Passed Board / University Year Result with percentage
       
       

9. Work Experience (If Applicable)
Name of Organization

 Designation

Total Work Experience
(in years)
     
     

10. Crossed Demand Draft / Cashiers Cheque No.____________dated__________Drawn in favour of______________________________ for Rs._________________________
 
(Bank draft / Cashiers Cheque must be drawn in favour of Bioinformatics Institute of India payable at New Delhi / Delhi. Participant is advised to write his/her name and address at the back of the demand draft)
** Important Note:
The program in which you are seeking participation, is BII's independent knowledge enhancement program, which gives insight about mentioned study areas. The program does not promise any job guarantee nor provides any specific eligibility to pursue higher studies. This is not a University/Government program. In case of any dispute, the jurisdiction of the same will be District Gautam Buddha Nagar Courts Noida, only. Fee once deposited is neither refundable nor adjustable under any circumstances.
*Mandatory to fill
BII:-:-:- Bioinformatics Institute Of In
**Declaration by the Participant

I declare that I have carefully read and understood the details of the above program and that i have given the true and correct information while filling up the form. It may be open for the Institute ot take action in case any of the information given by me is found incorrect.

Date : _____________
(SIGNATURE OF THE PARTICIPANT)
Place : _____________

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