IEE Registration Form

Student Registration Form

Fill out the form carefully for WORKSHOP registration
Choice of Study Centre *

Girish Park Howrah Park Street
STUDENT INFORMATION

Please ensure to fill all the mandatory fields carefully . This information will be printed on your ID Card
Preferred Mode of Study *

Offline - Classroom Teaching Online - Virtual Mode
Take Your selfie
Student Name *

First Name Middle Name Last Name
Birth Date *

Month Day Year
Gender *
Address *

Street Address

Street Address Line 2

City State

Pin Code Country
Student Mobile Number (Calling) *
Mobile Number *
Student Email
Courses *
Declaration by Candidate " I hereby agree to follow and abide by all the rules and regulations laid by the institute from time to time" . *

Clear
PARENT INFORMATION
Name

First Name Last Name
Email
example@example.com
Phone Number *
Please enter a valid phone number.
School Information

Enter your Class 12 School Details
Name of School Attended in Class 12 *
UID / Roll No ( Class 12 Exam ) Optional
Stream

Science Arts Commerce Others
Upload your Class 10 marksheet
Please verify that you are human *
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Student Registration Form