G.S.
Mandal’s
MARATHWADA INSTITUTE OF TECHNOLOGY
Chhatrapati Sambhaji Nagar
Accredited with “B” Grade by NAAC
Founder. Anandraoji Deshmukh (Freedom Fighter)
Recognized by Government of Maharashtra
Affiliated to Dr. Babasaheb Ambedkar Marathwada University, Chhatrapati Sambhaji Nagar
SMART INDIA HACKATHON 2024
PARTICIPANT REGISTRATION FORM
We are excited to have you participate in the Smart India Hackathon 2024! Please fill out the form
below to register your team. Ensure all fields are filled out correctly.
1. Personal Details of Team Members
Team Name: ___________________________________________
Number of Team Members: ___________________________________
(Maximum 6 members)
Name Gender Email Mob. No. Department
And Year
Team Leader
Team Member
Team Member
Team Member
Team Member
Team Member
Problem Statement Selection
Preferred Track/Theme:
Problem Statement Number:
Brief Explanation of Your Solution Idea: (Describe your solution idea in 150-200 words)
_________________________________________________________________________________
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Technical Skills and Experience
List of Technologies and Tools Your Team is Proficient In: (e.g., Python, Java, Machine Learning, IoT, Blockchain, etc.)
_____________________________________________________________________________
Plot No.37, N-4, CIDCO, Chhatrapati Sambhaji Nagar -431003(M.S.);India.Phone (Principal)(0240)2993742;
(Office):2993742 Email:
[email protected];
[email protected],Website: www.mit.asia
G.S.Mandal’s
MARATHWADA INSTITUTE OF TECHNOLOGY
Chhatrapati Sambhaji Nagar
Accredited with “B” Grade by NAAC
Founder. Anandraoji Deshmukh (Freedom Fighter)
Recognized by Government of Maharashtra
Affiliated to Dr. Babasaheb Ambedkar Marathwada University, Chhatrapati Sambhaji Nagar
_____________________________________________________________________________
Have You or Your Team Participated in a Hackathon Before? (Yes / No)
If Yes, Please Provide Details of Previous Hackathons:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Additional Information
Why Do You Want to Participate in the Smart India Hackathon? (100-150 words)
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Any Special Requirements for Your Team? (e.g., hardware, software, internet access, etc.)
________________________________________________________________________________
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Declaration
Declaration by Team Leader:
I, _____________________________ declare that all the information provided in this form is true
and accurate to the best of my knowledge. I understand that any false information may lead to
disqualification of our team.
Signature: ___________________________
Date: _______________________________
SPOC Mentor Mentor
Principal
Mr. M. S. Janjire
Plot No.37, N-4, CIDCO, Chhatrapati Sambhaji Nagar -431003(M.S.);India.Phone (Principal)(0240)2993742;
(Office):2993742 Email:
[email protected];
[email protected],Website: www.mit.asia
