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BSNL - IBT TRAINING ACADEMY (BITA)

1) Enrolment Fee / Course Fee payment can be made in the form of Cash/Chq (at par) / DD drawnin favour of Outlook Communications Pvt. Ltd payable at Hyderabad.

2) The Payment can also be made through e-banking/NEFT/RTGS. the details of BankA/C for thispurpose is given below. After making payment through e-banking/NEFT, the students shall

send an email furnishing full particulars of payment on email id

OR

(bsnlibt2015@gmail.com).

ADMISSION FORM

2. Enrolment Fee Payment Details

01.

02. 03

04.

05

06.

Name of the Student Mr./Ms ...............................................................................................

Sex: Male: [ ]: Female: [ ]: . Date of Birth: DD [ ] MM [ ] YY [ ]

Information about Family members:

a) Father/Husand Name : ......................................................................................................

. Address for Communication

ii)Address for Correspondence

................................................................., ........................................................................

................................................................., Pin ..................................................................

Contacts:

a) Email ID: .............................................................................

b) Landline: .............................. c) Mobile : ..............................

3. Personal Information

1. Mode of Payment

Cheque / D.D. No./NEFT Date Name of the Bank & Branch Amount

Training Venue

For office use only

Roll No.:.........................................................................................................................................

Batch No. : .................................Period of Training From ...........................To.............................

1.HyderabadNATFM, BSNL,

RTTC Campus, Gachibowli,

Hyderabad - 500 032

Connecting Success

IBTIBT INSTITUTE PVT. LTD

Bank Account No.115905000083

Name of the Bank &Branch

ICICI BankKalamassery, Cochi

IFSC Code.ICICI10001159

Sl.No.

ParticularsFee excluding ST where

ever applicableCheque / DD to bedrawn in favour of

Payable atDue Date for

Payment

1. Enrolment Fee Rs. 225/-

OutlookCommunications

Pvt. Ltd.Hyderabad

Along with this application

2. Course Fee Rs. 6742/-To be paid on or before

commencement of Training3. Course Material Fee Rs. 1500/-

5. Schedule of Payment of Fees

6. Hostel Facility Required : Yes Not Required

7. Declaration by the Student

1. I here by declare that all the information furnished by me in the application and the documents I have submitted in support of myapplication are true, complete and correct to the best of my knowledge and belief.

2. We understand and here by agree that :

Fees once paid will not be refunded

Hostel charges for lodging and boarding are extra

Place :

Date : Signature of the Candidate

8. Submission of Filled in Application Form

Duly filled in application along with enclosures may be sent to : The DGM (Trg) & BITA Programme Co-ordinator, O/o.

CGM, NATFM, BSNL, RTTC Campus, Gachibowli, Hyderabad - 500032

4. Academic

Qualifications:

UnderGraduate

Graduate

Post Graduate