Name : Application No : GATE Registration No : Name of the Course alloted :
I accept the above mentined course allotted to me
Accept the offer Accepted with upgradation Reject the offer (No upgradation will be allowed) (upgradation is allowed in 2 nd and 3 rd list)
(Note: Please tick one of the boxes above)
Date: (Signature of the Candidate)
Please mention your current postal address.
E- Mail id: Mobile No: Return the filled form to:
Officer-on-Special Duty (Academic Affairs) Indian Institute of Technology Bhubaneswar Samantapuri Bhubaneswar-751013 (Odisha)
Form-2
INDIAN INSTITUTE OF TECHNOLOGY BHUBANESWAR BHUBANESWAR-751013
PRE-REGISTRATION DEMAND DRAFT DETAILS
Please find enclosed a demand draft of Rs. 10,000/- dated ______________________________ in favour of IIT Bhubaneswar payable at Bhubaneswar.
Demand Draft No : __________________________________________________ Name of the issuing Bank : __________________________________________________ Place : __________________________________________________
Date: Signature of the Candidate
Return the filled form to:
Officer-on-Special Duty (Academic Affairs) Indian Institute of Technology Bhubaneswar Samantapuri Bhubaneswar-751013 (Odisha)