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Email ID: Branch ( B.Tech ) Course ( ) : Regular Crash Course Weekend Test-Series Summer Batch Interview Guidance Postal-Course
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Joining Date & Month (Applicable for classroom course only ): Mode of Payment ( ) : Cash deposit at Bank Cheque / Demand Draft Net Banking /Online Transfer
Name of Bank : ................................................................................... Bank Branch: ..................................................................... Date of Payment: D D M M Y Y Y Paid Amount : In case of Net Banking /Online Transfer provide us your Reference ID or Transfer receipt No. Page No. 1
2. Incase of Bank Deposite / Online Transfer, send your deposite receipt / transfer receipt copy at eiidelhi@gmail.com 3. Attach following documents along with your completely filled Registration form: (a) Two passport size photograph (b) One copy of Identify proof (Driving Licence, Voter ID, Passport, College ID) (c) Cheque / Demand draft / Payment proof. NOTE: (Must write your Name, Course and Mailing address with Mobile Number at the back side of the Cheque / Demand draft) Email Scan copy of completely filled Registration form along with above documents at eiidelhi@gmail.com OR Send your completely filled Registration form along with above documents through Courier or Speed Post at Head-Office address :
To, Engineers Institute of India (E.I.I.) 28B/7, Jia-Sarai, Near IIT Main Gate, Hauz-Khas, New Delhi PIN : 110016 Helpline: 011-26514888 www.engineersinstitute.com