Registration form

ITech Institute Chakwal

0335-552-2323

Date:_______
Full Name: ______________________________________________
Fathers Name: __________________________________________
D.O.B (dd-mm-yyyy):___-___-____
Gender: Male [ ], Female [ ].
NIC Number: ____________________________________________
City: ___________________________________________________
Occupation: _____________________________________________
Email Add.:______________________________________________
Phone No.:_______________ Phone 2: _______________________
Course Selected: CCNA[ ], CCNP[ ], CCNA Sec[ ], IELTS[ ], other[ ]
Fee installments: 1 [ ], 2 [ ].
Experience with IT: Yes [ ]. No [ ].
Preferred Time: Morning [ ], Afternoon [ ], Evening [ ].

Instructions:
Fill with block letters.
Fill only the desired box [ ] with X e.g. [ X ].
Attach a copy of your NIC.
Govt. Post Graduate College students are required to attach a copy of their student card as
well to get 12.5% discount on CCNA RS.
Registration form must be submitted along with fee one day prior to introductory class.
Fee is non-refundable.
Class timing may be different from your preferred timing.
CCNA Sec and CCNP RS students will be assessed before registration.
A Project of Ibne Seena International School Bhoun Road Chakwal .