ITB Infotech Pvt. Ltd.

Application Form 2016:

Name of the Candidate:
Fathers/Husbands Name:
Date of Birth:
Occupation:
Educational Qualification:
Sex:
Email Id:
Mobile Number:
Address:

State:

Mode of receiving payment (Money Order/Cheque/DD/Online Transfer):

Bank Account Number (If Payment mode is online transfer):
Account Holders Name:
Name of the Bank:
Branch Name:

Data Entry Plan (I/II/III):

Date of Registration Fee Deposit:
Amount of Registration Fee Deposited (Rs.3500/8000/12000):

Comments/Remarks:

www.itbinfotech.in

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