Apply to become our academic club member

Please fill the form if you are representing an academic organisation. This form is only meant for academic institution or department and not for any individuals or industries.

Name of the representer*

E-Mail of the representer*

Mobile no of the representer*

Designation of the representer*

Name of the department/Institution*

Eg. If you are filling in on behalf of the placement cell, you can mention it as the Placement department.

Few lines about the department, institution and address*

Fill the full name of the institution and the address. If the institution has multiple campuses, please mention the exact details properly. If you are applying for a specific college in a deemed university, please mention the same clearly.

Collaboration request*

Explain what are the expectations you are looking for in this academic club collaboration. Also do specify what are all the supports that you can render to us through this collaboration.

How you know BioLim?

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