Online Application Form
The ICFAI University, Tripura
Campus-based Programs 2017

Admissions Officer :
The ICFAI Univeresity Tripura,
Campus Address
University Campus, Agartala-Simna Road,
P.O. Kamalghat, Mohanpur,
Agartala-799 210, Tripura (West),
Ph: 0381-2865752/62,
Toll-free: 1800 345 3673
Fax: 0381-2865754
Email : admissions@iutripura.edu.in
website : www.iutripura.edu.in

 

   1. PLEASE SELECT THE PROGRAM YOU WISH TO ENROLL
 
 
   2. NAME OF THE CANDIDATE (use Capitals Only) [As it appears in the School certificates]

Prefix

:

Please upload your recent color Photograph (JPG / GIF format only)
(size 3.5 cm X 4.5 cm) 

(File size not more than
25-30 KB)

Name

:

   

(As it appears in the School Certificates)

 
   3. PERSONAL DETAILS (use capitals only)
 

Date of Birth

:

Blood Group

:

Mobile

:

E-mail

:

Tel (Res)

:

Nationality

:

 

Mailing/Postal Address Details

Permanent Address Details

Address

 

Address

 

City

 



City

 

State/UT

 

State/UT

 

Pin

 

Pin

 

Country

 

Country

 

 
   4. ACADEMIC RECORD: SCHOOL/ COLLEGE

a.

Class

Name of the School/College

City

Board */ University

Medium of Instruction

Year of Passing

% of Marks

X

XII

Graduation

Diploma/Others

* Indicate State Board/CBSE/ICSE etc., @ Applicable for MBA, MBA (Rural Management), MCA, MA (Education), B.Ed and B.Ed Spl. Ed (MR) candidates

b.

Name & Address of Institute last attended

:

 

City

:

State/UT

:

Pin

:

   5. TEST SCORES (If any)
 

Test

Test Name

Score

Rank

Application No

CLAT 2017 / ILSAT/ JEE (Main) / Tripura JEE

National / State Level Law Entrance Test

*In case the Scorecard is not available, please mention the App lication No. and later send the Scorecard to the Admissions Officer, ICFAI University, Sikkim.
 
   6. LANGUAGE PROFICIENCY

Please list languages.
The medium of instruction is English. All students are expected to have proficiency in speaking and writing good English.

Languages

Writing

Reading

Speaking

English

Other Languages


(Mother Tongue)

 
    7. DOMICILE STATUS
 
Domicile of North-East*          Non - Domicile
 
* If you are a Domicile student of Tripura, Please provide the Certificate at the time of Interview
 
   8. AWARDS AND RECOGNITIONS IN ACADEMICS AND SPORTS

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

Awards

Year

Basis

 
   9. SOURCE OF CONTACT (Please select or mention how you came to know about ICFAI)
 
Search Engine (Google/Yahoo/Bing/Others)        Website        Social Media (Facebook/Twitter/Other)

New Paper Article         Newspaper/Magazine advertisements       Electronic Media (FM/TV)     
        
Education Fairs       Friends          Events of IUT       Alumni/Students of IUT         Teachers   
   

Others       
 
   10. FAMILY BACKGROUND
 

a.

No. of Brothers :

No. of Sisters :

        

b.

Did any of them studied at IUT or any ICFAI Institute:
Yes No

 

Name of the Institute

 

Year of Passing

 

Course Completed

b. Parents Info

Father

Name

Qualifications

Occupation

Please Specify  :

Designation

Annual Salary/
Income

Organization
& Address

City

Pin

Ph (O)

STD Code

Number 

Mobile

Personal
E-mail

Company Website

 

Mother

Name

Qualifications

Occupation

Please Specify  :

Designation

Annual Salary/
Income

Organization
& Address

City

Pin

Ph (O)

STD Code

Number 

Mobile

Personal
E-mail

Company Website

 
   11 . MODE OF PAYMENT
 
Payment Mode
:
 
   12. DECLARATION
 

I have carefully read the academic and administrative rules and regulations as given in the Prospectus and Application Material/Website 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 issued 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 understand that the jurisdiction for all disputes (if any) relating to the ICFAI University, Tripura is Agartala. I hereby declare that the information provided by me in the Online Application is true and correct to the best of my knowledge. I have read, understood and agree to the rules and regulations of the ICFAI University, Tripura including my financial responsibilities.

  I Agree