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Registration Form
Training program at IIT Mandi for the residents of Himachal Pradesh.
Free Boarding and lodging at IIT Mandi during the course
No Registration & Training fee
Online/Offline mode of Trainings
Hurry up, Limited seatsĀ
Registrations are still ongoing!
The first batch shall be announced soon.
* Indicates required question
Email
*
Record my email address with my response
Name
*
Your answer
Aadhar card No
*
Your answer
Email ID
*
Your answer
Contact number
*
Your answer
Whether resident of Himachal Pradesh
*
Yes
No
Profession
*
Student
Faculty/Teacher
Working Professional
Self-employed
Other:
In the case of working professional or self-employed, kindly provide your Current Salary or income, and Profession Details. Otherwise, mention NA
*
Your answer
Do you require a residential facility at IIT Mandi?
*
Yes
No
How soon can you join the program?
*
Immediately
One week
One month
Other:
Education
*
ITI
Polytechnic
BCA
MCA
Engineering
Teachers
Trainers
Other:
Name of your Institute/Company/Organization
*
Your answer
Institute/Company/Organization Address
*
Your answer
Home Town
*
Your answer
District
*
Your answer
Block
*
Your answer
Correspondence Address
*
Your answer
Gender
*
Male
Female
Other
Age
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Whether BPL (Below Poverty Line)
*
Yes
No
Required
Whether PWD
*
Yes
No
Required
Emergency contact number
*
Your answer
Father's name
*
Your answer
Father's contact no:
*
Your answer
Mother's name
*
Your answer
Religion
*
Your answer
Caste
*
Your answer
Covid 19 Vaccination status
*
Vaccinated with first dose
Vaccinated with second dose
Vaccinated with booster dose
Not Vaccinated
I acknowledge that all the information filled above is true up to my best knowledge. If I am found to falsify any of the information, I will be immediately disqualified from the course
*
agree
Required
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