1. Application for*:

• 15 Days Training    
• 1 Month Training   
• 2 Months Training 
• 2 Months Project   
• 3 Months Project   
• 4 Months Project   
• 6 Months Project   

2. Subject*:

• Basic Microbiology         
• Medical Microbiology    
• Industrial Microbiology  
• Bioinformatics                 
• r-DNA Technology         
• Molecular Biology          
• Plant Tissue Culture       
• Immunology                   
• Proteomics                      

3. Hostel Facilities Required: Yes No

4. Name of Applicant*:

5. Father’s Name*:

6. Mother’s Name*:

7. Permanent Address*:

8. Pin Code*:

9. Phone No.:

10. Name of College*:

11. Address of College*:

12. Mobile No*:

13. E-mail ID*:

14. Date of  joining (DD-MM-YY) *:

15. Educational Qualifications*:

• High School:
  
• Intermediate:
  
• B. Sc. (I Year):
  
• B. Sc. (II Year):
  
• B. Sc. (III Year):
  
• M. Sc (I Semester):
  
• M. Sc (II Semester):
  
• M. Sc (III Semester):
  
• M. Sc (IV Semester):
  
• Ph.D./Research Scholar:
  

16. Have you undergone training in Biotechnology before?  Yes No

                                                        If Yes, then write the Name & Address of Research/Training Center's:
                                                       

17. Mention the techniques learned/handled during your previous training (if applicable):
                                                       

18. Demand Draft No.*:

(NOTE: Demand Draft should be in favor of “Institute of Biotechnology & Research Center” payable at Agra)

19. Name of the issuing bank*:

20. Amount of Demand Draft*:

21. Upload Your Recent Passport Size Photograph*:

(NOTE: Please Click on Browse button to select Photo, Size Should be 100x100)