CSI YOUNG TALENT SEARCH IN COMPUTER PROGRAMMING 2017 – REGISTRATION FORM

To be filled in and returned to The Director (Education), Computer Society of India, Education Directorate, National Headquarters, C.I.T. Campus, 4th Cross Road, Taramani, Chennai – 600 113 so as to reach on or before 1st July 2017. You may also send your nomination by email to in word format

1.Name of the School and Postal Address with PIN Code / Phone Number with STD Code
E-Mail ID

2. Co-ordinator : ______E-Mail ID ______

Telephone with STD Code ______. Mobile No. ______

3. Principal : ______E-Mail ID ______

Telephone with STD Code ______. Mobile No. ______

4. Team members nominated (Name should be in CAPITAL letters and spelt carefully – Only those born on or after 1st January 1999 are eligible.

Sl. No. / Name of Team Member / Std.
(Class) / Sex
M/F / Date of
birth / Home Address, Phone Number with STD Code and E-mail Id
1.
2.
3.

5. Choice of Test Centre (Please rank 3 centres in order of preferences)

Allahabad / Bangalore / Bhilai / Bhubaneswar / Chandigarh
Cochin / Coimbatore / Chennai / Goa / Guwahati
Hyderabad / Kolkata / Lucknow / Mumbai / Nashik
New Delhi / Pune / Rourkela / Trichy / Udaipur
Vadodara

6. Programming Language to be chosen by the team [tick ( √ ) any one language] :

Turbo C / Turbo C++ / Dev C++ / Java 7
(Command line) / BlueJ 3.0.9
(Editor)

7. Entry Fee Details :

DD No./Transaction ID / Date / Bank / Branch / Amount
Rs.600/-

I certify that

a)  The details mentioned above are true to the best of my knowledge and belief

b)  The dates of birth as above have been verified by me from official records and found to be correct

I agree to abide by the rules and regulations of CSI/SEARCC for the event

Place :

Date : Signature of the Principal with seal