Please affix your latest Passport Size Photograph here
 
BIRLA INSTITUTE OF TECHNOLOGY

INTERNATIONAL CENTRE

BAHRAIN

 

APPLICATION FOR ADMISSION

Academic Session 2008-09

(Before filling up the application form, please read the Instructions carefully)

Applicant:  (To be filled-up by the candidate)

Name of the Candidate

Course applied for in order of preference (Circle the preference) *

Contact Numbers

 

I

BE / BBA / B.Com. / B.Sc.(IT) / MBA

Tel:

 

II

BE / BBA / B.Com. / B.Sc.(IT) / MBA

Mobile:

*Candidates applying for Undergraduate programmes from 6+3+3 stream with Tawjihia certificate would be required to undergo a preparatory course for 1 year

 

For office use only

1. Application No. :….…..     Processing fee deposited: ….…..    Receipt No. :….…..     Date:….../..…./…....

2. Date of Interview / Selection:….../..…./…....                           Whether selected / not selected: Yes / No 

    If yes, whether Admission letter sent: Yes / No                        If Yes, Date:….../..…./…....

Fee deposited

 

Check list

Particulars

Amount

Receipt No.

Date

Particulars

Requested

Undertaking given

Yes

No

Yes

No

Date

Tuition Fee

 

 

 

Transportation

 

 

 

 

 

Caution Fee

 

 

 

Accommodation

 

 

 

 

 

Transportation Fee

 

 

 

Other assistance

 

 

 

 

 

Examination Fee

 

 

 

Remarks (if any):

Student Activity Fee

 

 

 

 

Others (……………)

 

 

 

Signature of the Administrative Officer

 

Instructions:

1.       Application Form is to be filled-up in English and in Block letters.

2.       Please sign the undertakings as given at the end of the form.

3.       Incomplete Applications are liable for rejection.

4.       The following enclosures are to be sent along with the filled-up application form: (Confirm attachments by ticking Ö  in appropriate boxes)

□    Copy of Degree Certificate along with statement of marks for MBA courses.

□    Copy of the statement of marks at Secondary School Certificate (10th standard of CBSE) / ‘O’ level and AISSCE (12th standard of CBSE) / ’A’ level / IB / or equivalent examinations.

      (Students appearing for the qualifying examination may also apply. However they will be required to submit the statement of marks of the qualifying examination on or before June 14, 2008.)

□    A demand draft of BD (Bahrain Dinars) 25/- drawn in favor of JALAL-BIT payable at Manama branch of HSBC Bank, to cover the processing fee.

□    A formal Character Certificate from the Head of the Institution last attended.

□    5 Passport size photographs with full name written on reverse. (includes one to be pasted on the form)

□    2 Photocopies of the relevant pages of Applicant’s & Father’s/Legal Guardian’s Passports & CPR to show the Passport and Residence Permit details.

5.       For Institutional assistance in respect of Transportation / Accommodation / Visa, please fill up the appropriate application form supplied with this admission application form.

 

I. Personal Data

1.

Full Name

:

…………………………………………………………………………..

2.

Father’s Name

:

…………………………………………………………………………..

3.

Gender

:

 

 

Male

 

Female

 

4.

Date of Birth

:

 

Date

Month

Year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

Nationality

:

…………….

If residing in Bahrain, indicate CPR No.: ….…………….

6.

Passport Details

:

Passport No.

:

…………….

Place of Issue

:

…………….

 

 

 

Date of Issue

:

…………….

Date of Expiry

:

…………….

7.

Permanent Home Address

:

...……………………………………………………………..

 

…………………………………………………………………………………………………..

 

…………………………………………………………………………………………………..

 

Telephone

:

…………...

Fax

:

……………

E-Mail

:

………………….

8.

Address for Correspondence

:

..……………………………………………………………..

 

…………………………………………………………………………………………………..

 

…………………………………………………………………………………………………..

 

Telephone

:

…………...

Fax

:

……………

E-Mail

:

………………….

9.

Person and address to be contacted in case of emergency

:

………………………………

 

…………………………………………………………………………………………………..

 

…………………………………………………………………………………………………..

 

Telephone

:

…………...

Fax

:

……………

E-Mail

:

………………….

 

10.

Whether Visa Assistance required *

:

 

Yes

 

No

 

(If yes, the candidate must notify the Institute in writing, at least 2 months in advance.

For further details, please contact the admission office.)

 

 

11.

Whether Accommodation assistance required *

:

 

Yes

 

No

 

(If yes, the candidate must notify the Institute in writing, well in advance.

For further details, please contact the admission office.)

 

 

12.

Whether Transportation required *

:

 

Yes

 

No

 

*Conditions apply.