Bioinformatics Institute of India
C56A/28,Sector-62, Noida-201301, U.P (Noida)
 

Life Science Department
Application Form
Distance Learning Program
 
Select Any One From Following List :
Industry Program in Bioinformatics
Industry Program in Intellectual Property Rights
Industry Program in Biotechnology
Industry Program in Forensic Science
Introductory Program in Bioinformatics
Proficiency Program in Medical and Healthcare Informatics
Participation No.
(For Office use only)
Paste your self attested photograph
All columns are compulsory, No column should be left blank, All in block letters
1. Participant's Name
____________ ____________
(First) (Last)
2. * Father's / Mother's Name _______________________________
3. Date of Birth
               
    (DD       MM           YYYY)
4. Sex
Male
Female
5. Address for Correspondence __________________________________________
State _____________________ PIN ________________
  Country ___________________ Nationality ___________________
6. Telephone numbers (Code)_________(O)_____________(R)_____________
(Mob)_____________
7. e-mail ______________________________________
8. Academic Qualifications
Exam Passed Board / University Year Result with percentage
       
       

9. Work Experience (If Applicable)
Name of Organization

 Designation

Total Work Experience
(in years)
     
     

All columns are compulsory, No column should be left blank, All in block letters
10. Crossed Demand Draft / Cashiers Cheque No.____________dated__________Drawn in favour of______________________________ for Rs._________________________
 
(Bank draft / Cashiers Cheque must be drawn in favour of Bioinformatics Institute of India payable at New Delhi / Delhi. Participant is advised to write his/her name and address at the back of the demand draft)
** Important Note:
The program in which you are seeking participation, is BII's independent knowledge enhancement program, which gives insight about mentioned study areas. The program does not promise any job guarantee nor provides any specific eligibility to pursue higher studies.In case of any dispute, it would have to be got resolved through arbitration under Arbitration and Conciliation Act 1996 by the sole arbitrator appointed by Bioinformatics Institute of India, Noida. The jurisdiction of the same will be to the Courts of District Gautam Buddha Nagar, Noida only.Fee once deposited is neither refundable nor adjustable under any circumstances.
*Mandatory to fill
*For downloaded forms from internet add Rs.300/- as application processing fee to the Program Fee.
BII:-:-:- Bioinformatics Institute Of In
**Declaration by the Participant

I declare that I have carefully read and understood the details of the above program and that i have given the true and correct information while filling up the form. It may be open for the Institute ot take action in case any of the information given by me is found incorrect.

Date : _____________
(SIGNATURE OF THE PARTICIPANT)
Place : _____________

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