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For Admission in Advanced Diploma in Banking Technology-IV (2010)

This document is an application form for admission to the Advanced Diploma in Banking Technology-IV program for 2010. The form requests personal details such as name, date of birth, address, education history, work experience, and payment details. It also includes instructions to submit required documents along with the completed application form and application fee. Upon acceptance, an admit card will be provided with exam details such as date, time, and location.

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himanshu2k10
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© Attribution Non-Commercial (BY-NC)
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Download as PDF, TXT or read online on Scribd
121 views

For Admission in Advanced Diploma in Banking Technology-IV (2010)

This document is an application form for admission to the Advanced Diploma in Banking Technology-IV program for 2010. The form requests personal details such as name, date of birth, address, education history, work experience, and payment details. It also includes instructions to submit required documents along with the completed application form and application fee. Upon acceptance, an admit card will be provided with exam details such as date, time, and location.

Uploaded by

himanshu2k10
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FORM

For admission in
Advanced Diploma in Banking Technology-IV (2010)

Registration No.:
Affix Photo
(To be allocated by the Institute) Sign across the
1. Personal Details photo in a way that
part Signature
1.i. Name: Mr / Ms_________________________________ come on photo and
(In capital letters) part on the paper

(as it appears in your Degree / High School Certificate)


1.ii. Date of Birth (dd / mm / yyyy)____________________
1.iii. Nationality ______________________________
1.iv. Category SC ST OBC General
1.v. Father’s Name ____________________________
1.vi. Address for Communication ______________________
___________________________________________
____________________________________________
City______________ Pin Code ___________
1.vii. Phone (with STD Code) __________________________
1.viii. Mobile No. ______________________________________
1.ix. E-mail __________________________________
Parents/Guardians’ information

1.x. Name __________________________


1.xi. Phone (with STD Code) __________________________
1.xii. Mobile No. ______________________________________
1.xiii. E-mail __________________________________
2 . Educational Qualifications:

Name of the Year of Name of Major Certificate/ Overall


Course Passing School/College/ Subject Degree %age and
University and Obtained Division
Place
X Std

XII Std

Graduation*

Post
Graduation
Others (IF
Any)

*In case of GPA/CGPA score, please also give conversion formula.

3. Work Experience:

(Begin with the most recent, including any short-term assignment)

Period Organisation Job Title Key Responsibilities


From- To (Dates) Name & Address
4. Particulars of Draft:

Draft. No. _________________ Date: ___________ Amount: ` 1000/-


for “ PNBIIT A/C ADBT ”.
Issuing Bank: __________________________
Payable at: LUCKNOW

I have read the complete details of the programme alongwith terms and
conditions and disclaimer statement as given in the information booklet and
have fully understood them. I also declare that the information given by me in
the application form is true and correct and understand that any falsification
and/or suppression of material information will render my candidature invalid
and I may be denied admission / expelled from the programme.

Date: Signature:____________________
Place:

Please enclose self attested photo copies of following documents along with
the application:
1. Degree Certificate(s) and certificates of std. X, XII and each year/semester
of college, alongwith supporting mark sheets.
2. Required certificate of category, if applicable.
Note:
1) Incomplete applications without supporting documents will not be
considered
2) Application Fee: ` 1000/- payable by Demand Draft favouring “Punjab
National Bank Institute of Information Technology A/C-ADBT”, payable at
Lucknow.

3) Completed application forms along with the DD should be sent to

The Programme Coordinator,


ADBT-IV (2010)
Punjab National Bank Institute of Information Technology,
Vibhuti Khand, Gomti Nagar,
Lucknow-226010.
ADMIT CARD

(Complete Self- Correspondence address with Pin Code)

TO
Mr / Ms _____________________ Affix Photo
(In capital letters) Sign across the
Address ____________________ photo in a way that
part Signature
come on photo and
___________________ part on the paper
______________________________

(FOR OFFICE USE ONLY)

REGISTRATION NUMBER: ________________ADBT-IV (2010)

PLACE OF ONLINE ENTRANCE TEST: PNBIIT


Vibhuti Khand, Gomti Nagar,
Opp. Lohia Hospital
Lucknow.

DATE & TIME OF ONLINE ENTRANCE TEST: ________

REPORTING TIME : _________

NOTE :

1. No expenses will be reimbursed for the journey undertaken for attending


the Online Entrance Test/ Interview.
2. The candidate should bring this ADMIT CARD with him/her at the
Examination Hall.

Programme Coordinator

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