Nehru Institute Of Mountaineering-Online Registration

Online Registration Request Form

1.	Personal Information
1.1	Name of Student	:
1.2	Date Of Birth	:
1.3	Gender	:
1.4	Occupation	:


2.	Correspondence Details
2.1	Permanent Address	:

2.2	City	:
2.3	State	:
2.4	Pincode	:
2.5	Telephone No	:
2.6	Email Address	:


3.	Cources to Attend
3.1.	Course Name	:
3.2	Course Serial No.	:


4.	Previous / Last Attended Course
4.1	Have u attended any course before	:	Not Attended any Course before




I have read the rules and regulations of NEHRU INSTITUTE OF MOUNTAINEERING, UTTARKASHI relating to the courses of training in Mountaineering/Advanture/Search & Rescue/ Method of Instruction/ Guide and have fully understood the meaning and significance of the same. The above entries have been made by me and they are true and correct.