ITM, LUCKNOW
 Student Registration
 
Admission to : *
Only for B-Tech   UPTU Rank :
Applicant Name : *
Date Of Birth :*  Pick a date
Father's Name : * Occupation : Department :
Communication
Address :*
   
City: Pin Code :
Telephone: Mobile
Nationality : Sex: Category :
Academic Qualification :
Examination Board/University Year of Passing % Obtained Div/Grade Subject
High School (10th Standard)    
Intermediate (10+2 Standard    
Graduation    
Marks Obtained in (only for B. Tech)
Physics   Chemistry Maths/Biology
PCM / B Total marks obtained %age of PCM / B