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Institute of Chemical Technology

Network Registration Form for


Student on Laptop/Desktop
Full Name of the Student:
Department:
Admission Year:
Masters / PhD (year) :
Hostel no:
Room no:
Contact no:
Mobile no:
Personal Email ID:
Physical (mac) Address of wireless card:
Physical (mac) Address of LAN card of desktop:
Signature of Applicant:
Signature of HOD / Guide / Hostel Administrative officer:

(Note: Network registration will take 48 hours)


Please bring your laptop at IPC while submitting application the connections will not be
given on tabs, mobile etc.

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