New User Registration Form

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Indicates all the fields are mandatory

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User ID:






(Contains only letters (a-z), numbers (0-9) and underscore)









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Password:






(Password should be of minimum 4(four) and maximum 10(ten)
characters.)

*Re-Type
Password:

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If you forget your password, you can retrieve it by
answering
your
unique hint question.

Frame your question such that only you know
its answer.

*Select
a question forgetting password
: Select a hit question ? What is your favourite multimedia software? What is your favourite game? who is your favourite Cricketer? who is your favourite Film Actor? what is your favourite food?





*Hit

Answer:




(Write

Your Answer)

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MM
YYYY





*Date
of Birth:

Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Month JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Year 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

*Gender
:
Male
Female

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Student First Name: Middle Name: Last Name: Academic Year: Year First Second Third Fourth Year of Admission:15 Select Year 1990 1991 1992 1993 1994 1995 1996 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Department: Select Department Information Technology Computer Sc. & Engineering Electronics & Communication Electrical Engineering Mechanical Engineering Civil Engineering Roll: &nb sp; (Eg.2k1_612::Here 2k1 stands for year 2001:: 1,2,3,4,5,6 for dept Civil,Elect,Mech,Comp,Ece and IT::Left digits indicates roll no) Hostel No: Select Hostel Hostel 1 Hostel 2 Hostel 3 Hostel 4 Ladies Hostel Room No : Contact No: - Mobile No: Email:

General First Name: Middle Name: Last Name: Select City: City BANGALORE CHENNAI DELHI KOLKATA MUMBAI Other : (If other city please specify) Select State: State ANDRA PRADESH BIHAR DELHI JAMMU & KASHMIR HARIYANA KERAL MADHYA PRADESH MAHARASTA ORRISSA RAJASTAN UTTAR PRADESH WEST BENGAL Select a Country : Country AFGANISTAN BANGLADESH BARMA BHUTAN JAPAN INDIA NEPAL PAKISTAN SRI LANKA Zip Code: Pincode 700001 700002 700003 700004 700005 700006 700007 700008 700009 700010 700011 700012 700013 700014 700015 700016 700017 700018 700019 700020 700021 700022 700023 700024 700025 700026 700027 700028 700029 700030 700031 700032 700033 700034 700035 700036 700037 700038 700039 700040 Other: (If other Zip please specify) Contact No: - Mobile No: Email:

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