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Corporate Office: 4/488, Ground Floor, Vibhav Khand, Gomti Nagar, Lucknow- 226010 (UP) India
Tel: 0522 430 64 64 Mo: 95 59 196 700, 99 35 172 366, 95 54 064 000
self attested
photograph
Participation No.
(For office use only)
All columns are compulsory, No column should be left blank, All in block letters
1. Candidate’s Name*
3. Date of Birth* (D D M M Y Y Y Y)
Post / Town:
7. E-mail*
8. Last Academic Qualifications* Exam Passed Board / University Year Result with Percentage
Payment Details:
10.Crossed Cheque / Cash / Demand Draft No. _______Dated________ Drawn on _______________ for Rs. __________
(Bank Draft/ Cheque must be drawn in favour of "CIS Studies, Lucknow" payable at “Lucknow”. Candidates are advised to write their
name and address at the back of demand draft / Cheque)
You may also pay the Corse Fee by Online Internet Banking / NEFT / RTGS in Institute Account.
*Only at par / Multicity cheque will be accepted
11Documents to be attached with application form:
i) Fee DD/ Cheque ii) Photocopies of Last Academic Qualification with self attested
iii) 2 Copies of Passport size photograph one pasted and one pinned
Note: At par Cheque only accepted.