Institute of Chemical Technology

Network Registration Form for Student on Laptop/Desktop

Full Name of the Student:

Department:

Admission Year:

Masters / PhD (year) :

Hostel no:

Room no:

Contact no:

Mobile no:

Personal Email ID:

Physical (mac) Address of wireless card:

Physical (mac) Address of LAN card of desktop:

Signature of Applicant:

Signature of HOD / Guide / Hostel Administrative officer:

(Note: Network registration will take 48 hours)

Please bring your laptop at IPC while submitting application the connections will not be given on tabs, mobile etc.