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*INSTRUCTIONS BEFORE FILLING THE APPLICATION
1. All fields marked with * are mandatory
2. Please have scanned soft copies of your Passport Photo, Birth Certificate and Marks Memo of qualifying exam ready for upload
3. Passport details are mandatory for foreign citizens, OCI and PIO card holders
4. Application fee of Rs. 500 has to be paid online using NetBanking, Debit Card or a Credit Card

Application form for Admission Test - IUTAT

PERSONAL DETAILS

* Student Name:
(As per the 10+2 Certificate)
* Father Name: * Mother Name:
Date of Birth: Blood Group:
Identification Marks:
(As per the SSC Certificate)
* 1.
2.
Marital Status: Married Unmarried * Mother Tongue:
SSC / X H.T.No:
* Nationality: Indian Other
Aadhar Card No: * Native Place & State:
Citizenship: Passport No:
* Student Mobile: * Student E-mail:
* Father Mobile: Mother Mobile:
Gender: Male Female Transgender
* Test Type: Online Offline
* Test State: * Test Center:
* Test State: * Test Center:
* Test Date: * Test Timings:
* Test Date: * Test Timings:

DOMICILE STATUS

DOMICILE STATUS: International Domicile Non-Domicile

ACADEMIC RECORD: SCHOOL / JUNIOR COLLEGE

X XII
Name of the School / College
City / Town / Village
Board / University
Medium of Instructions
Year of passing
Aggregate % of Marks / CGPA
Name & Address of the School / College
(for Class XII or equivalent)
City
State
Pin

LANGUAGE PROFICIENCY

The medium of instruction at ICFAI University is English. All applicants are expected to have proficiency in speaking and writing good English.
Lnaguages Writing Reading Speaking
English Good Fair Nill Good Fair Nill Good Fair Nill
Good Fair Nill Good Fair Nill Good Fair Nill
Good Fair Nill Good Fair Nill Good Fair Nill
Good Fair Nill Good Fair Nill Good Fair Nill

AWARDS AND RECOGNITIONS IN ACADEMICS AND SPORTS

List awards, distinctions, honors and scholarships (academic, extracurricular, community services etc.)
Awards Year Basis

SOURCE OF CONTACT

Please mention how you came to know about ICFAI
Newspaper Article Newspaper Advt. Social Media Website Electronic Media Educational fairs Friends Others
Others (Please specify)

WHY DO YOU WANT TO JOIN THE B.TECH. PROGRAM? Describe briefly


COURSES OFFERED

* Courses offered:
B. Tech
Civil Engineering
Computer Science and Engineering
Electronics and Communication Engineering
Mechanical Engineering
Electrical and Electronics Engineering

COMMUNICATION DETAILS

Permanent Address
Country: State: District:
H.No: Locality: Village/City:
Mandal: Pincode:
Tel: (R): (O)
Same as Permanent Address
Address for Communication
Country: State: District:
H.No: Locality: Village/City:
Mandal: Pincode:
Tel: (R): (O)

FAMILY BACKGROUND

No. of Brothers: No. of Sisters
Father Mother
Qualification
Occupation
Designation
Organization & Address
Annual Income
Email
Total Family Income (per annum) Above 7 lakhs 5 - 7 lakhs Below 5 lakhs

HOW DO YOU PROPOSE TO FUND YOUR EDUCATION?

Own resources Loans from Relatives / Others Educational Loan from Banks Parent's Support

OTHER ADMISSION CRITERIA

Whether Disabled: Yes No If Yes please specify the Category:
Participation in Sports: Yes No If Yes: International National State
Community SC ST BC-A BC-B BC-C BC-D OC Other Any other Please Specify:

PHOTOS AND DOCUMENTS

* Upload Your Photo here : (Maximum File Size is 1 MB,
Formats Supported: jpg, png, gif, bmp, jpeg, JPG, PNG, GIF, BMP, JPEG)


Memorandum of Marks (Inter) : (Maximum File Size is 1 MB,
Formats Supported: jpg, png, gif, bmp, jpeg, pdf, JPG, PNG, GIF, BMP, JPEG, PDF)


Copy of Passport : (Maximum File Size is 1 MB,
Formats Supported: jpg, png, gif, bmp, jpeg, pdf, JPG, PNG, GIF, BMP, JPEG, PDF)


Copy of Birth Certificate : (Maximum File Size is 1 MB,
Formats Supported: jpg, png, gif, bmp, jpeg, pdf, JPG, PNG, GIF, BMP, JPEG, PDF)


Eligibility / Equivalent Course Certificate : (Maximum File Size is 1 MB,
Formats Supported: jpg, png, gif, bmp, jpeg, pdf, JPG, PNG, GIF, BMP, JPEG, PDF)



DECLARATION

I have carefully read the academic and administrative rules and regulations of the B.Tech. Program as given in the Prospectus and Application Material and agree to abide by the same. I understand that these rules are only indicative and the complete list of rules and regulations as updated from time to time will be given to me on my enrollment in the form of Student Handbook and / or any other communication issues from time to time. I also understand that the ICFAI University, Tripura reserves the right to change/modify the rules and regulations from time to time and I agree to abide by the same. I agree to pay the fee as per the schedule of fee payment stipulated. I understand that in case I withdraw from the program after 15 calendar days, from the date of registration, for reasons whatsoever, I will not be entitled to claim any refund of amount paid to the ICFAI University, Tripura. In the event of any dispute, I hereby declare and state that, I will not approach any Court of Law and/or seek redressal under the provisions of the Consumer Protection Act 1986 without first exhausting the remedy from the Arbitration. I hereby declare that the information provided by me in the Application is true and correct to the best of my knowledge. My signature below certifies that I have read, understood and agreed to the rules and regulations of the ICFAI University, Tripura including my financial responsibilities.
* I Agree with the declaration mentioned above.
* Date: Signature of the Applicant Signature of the Mother Signature of the Father / Guardian

Application Fee : 500

Payable Amount : 500


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