Online Registration Form

REGISTRATION FORM
(Mark the appropriate choice)
PERSONAL DETAILS
1. Name (In English Block Letters) :*
2. Date of Birth :*
3. Gender :* Male  Female
4. Father's Name :* Occupation
    Mobile :*   Email
5. Mother's Name :* Mother's
Occupation: 
CONTACT DETAILS
6. Permanent Address :*
Email ID :*
Phone : (O)   (R)   (M) 
7. Correspondence Address:
OTHER DETAILS
8. Course :
9. Branch :
9. Branch :
9. Branch :
10. JEE Main Rank / Jeep
All India Rank :* Overall       Category 
State Rank :* Overall       Category 
11. Roll No. in Qualifying Exam:*
12. Other Details
Class X%
Class XII %
PCM%
Graduation%
Applied For Bank Loan
13. Admission Category : Through Counseling    Management Counseling
14. Seat Category:   General SC    ST OBC   Others (Specify)
15. Hostel Required Not Required
16. Transportation Required Not Required
17. Source of Information about Doon Group of  Institute. 
Hoardings      Dainik Jagran  Times of India  Internet 
Kiosks     Amar Ujala        Others   
18. Bank Name :  Bank Draft No.*   Payable at P.N.B. Raiwala, in favour of D.I.E.T. Shyampur (Registration Fee Rs. 2,000 /- )
 

For Online Payment our Bank Details is Below

 

UPLOAD RECORDS
19. Please upload your recent photograph :
20. Signature of  Candidate :
21. Signature of Parent/Guardian :
 
Name : Date : 24-May-2017
Enter the Code as shown in Image :
            
BANK DETAILS
Bank Name : PUNJAB NATIONAL BANK
Account No : 0922002100100823
IFSC Code : PUNB0092200
Alumni  Membership  Membership
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