INSTITUTE OF ENGINEERING & MANAGEMENT TRUST

(IEMT)
Admission office: GN-34/2, ASHRAM, Salt Lake Sector - V, Kolkata - 700091, Ph: (033) 2357 2059 / 2357 2995 / 09007303598

In case of any complain please e-mail us at : [email protected]

AD M I SS IO N F OR M
For the session 20 _ _
Course applied for *: B.Tech / BBA / BCA / M.Tech / MBA / PGDM / M.Sc. / MBA (DLP)
Stream (for B.Tech & M.Tech)
*Please tick your choice

1. Name : Mr./Miss/Ms. :
2. Date of Birth :

Affix a passport size

colour photograph
& provide one
more copy for
identity card

3. Address :a) Present :

b) Permanent :

c) Contact Tel. No. : Residence :

Mobile :

d) Email id:
4. Do you need Hostel Accommodation : Yes / No (We have limited hostel accommodation).
5. Fathers Name :

Phone No.:

6. Mothers Name :

Phone No.:

7. Guardians Name :

Relation :

Full Office Address, Designation & Ph. No. :

Phone No. : Office :

Residence :

Monthly Income :

8. Do you have any Manager / Engineer / Businessman in the family ?

(Give detail position held with designation, address & phone nos.)
(a)
(b)
(c)
(d)
9. Are you a NRI as per RBI guidelines ?
10.Are you a foreign student ?

Citizen of ?

11. Academic Qualifications [Starting from Madhyamik (10th standard)]. Xerox copies of all Marksheets must be attached.
CERTIFICATE/

.DEGREE/DIPLOMA

NAME OF
SCHOOL/COLLEGE

YEAR

NAME OF BOARD/
UNIVERSITY

SUBJECTS

12.Percentage of marks obtained in English language at a) Madhyamik level :

% OF MARKS IN
AGGREGATE

b) H.S.level :

DIVN./CLASS/
GRADE

13.Track record of leadership activities :

14.How will you enrich the student life in the institute ?

15.What are your short term goal in life (5 years) ?

16.What are your long term goals in life (20 years) ?

17. Preferred Contact time

18. Do you have driving licence ? Yes

No

If yes, please give following details :

Licence number ___________________ Year of Expiry ________________ Issued at _____________________

19. Do you have Passport ?

Yes

No

If yes, please give following details :

Passport number ___________________ Year of Expiry ________________ Issued at ____________________

(In case you do not have passport, you need to apply for a driving licence, passport immediately on admission).
20. Other Academic Qualifications (Certificates/Diploma in Sports/Cultural/Volunteering/Other courses)
Programme

Board / University

Institution

Year

21. Employment Details (In reverse chronological order)

(Please give details of full-time job/jobs done after graduation)

Organization

Year
From

To

22. Extra-Curricular Activities and Hobbies :

Duration
(in months)

Designation

Gross salary
(Rs. per month)

Role

23. Source of information about IEMT :

Advertisement in ________________________ Newspaper

Brochure/Poster

Advertisement in ________________________ Magazine

Friends

College/teachers

Internet/website

Friends/Relatives

Other (please specify) _________________________________________________________________________

24. Admission Tests :
e-MAT /

CAT /

MAT /

XAT /

JEMAT /

WBJEE /

IITJEE /

AIEEE Registration No. : ______________

Score : __________________ Rank : ____________________ Others (Specify) : ____________________________

__________________________________________________________________________________________________
IEMT institutes use the above admission test Scores for short listing candidates for GD/PI. IEMT institutes
conducts its admission process and counselling on the basis of inter-se merit for admitting students.

Voluntary Declaration
We, the undersigned signatories as student and guardian hereby agree to abide by all rules and regulations which are in force or will
be framed from time to time by the Institute authorities. We also understand that the institute is private self-financed and hence timely
payment of fees is of paramount importance. W e agree and undertake to pay fees within seven days of commencement of the
semester, failing which the students name will be struck off from the Register and consequently he/she will cease to be a student of
the Institute from that date.
Any damage caused to Institute property will have to be replaced/purchased/compensated by the student immediately, failing which
his/her name will be struck off from the roll of the Institute. Bunking of classes, creating noise, smoking, consumption of intoxicating
materials or any such act which may disturb smooth functioning of the Institute will be dealt with seriously and may result in
disciplinary action against the student.
We further undertake not to participate or organize any type of organizational activities without the written permission of the Institute
authorities during the study period. Any type of indiscipline as mentioned or not mentioned above on the part of the student will result
in his/her summary expulsion from the Institute and the decision of the authorities of the Institute will be final and binding on all
concerned. If anybody individually or collectively indulge in indiscipline, the authorities may suspend classes sine-die. As both boys
and girls are expected to come to the Institute in formal dress which looks decent and sober, we hereby agree to adhere to the same.
We are aware that students are required to attend 100% classes. Upto 20% absence may be permitted by the Institute for medical
reasons to be substantiated with documents. If the attendance is less than 80%, the student will not be allowed to sit for any exams
and he/she will be asked to repeat the academic year. We have understood that failure to attend classes affects students in many
ways such as;
i)

Difficulty in following subsequent lecturers.

ii)

Proportionate deduction of internal marks.

iii)

Poor attendance will cause adverse remark during placement.

iv)

Institute may refuse to provide placement assistance to students with inadequate attendance.

W e also understand that IEMT institutes are secular in nature and no religious activities or religious dress of any kind will be
permitted within the campus at any time.
We have fully understood that IEMT institutes provide placement assistance but does not guarantee employment to students. We are
fully aware that

employment is ultimately the responsibility of the individual student and depends on a variety of factors such as state

of the economy, attitude of the student, smartness, technical/managerial knowledge, personal skills and overall academic performance.
On any matters whatsoever pertaining to the Institute and also regarding amount of fees, discipline, code of conduct, academic
matters, timings etc., the decision of the management of the Institute will be final and binding on us.

Undertaking
1) We hereby undertake and agree to the admission being subject to jurisdiction of courts at Kolkata.
2) We have carefully studied the rules and regulations of admission as given in the prospectus and explained to us and we
shall in matters of interpretation, accept the decision given by the authorities as final and binding.
3) We shall conduct ourselves as per the rules, regulations and norms of the Institute failing which the student is liable to be
debarred from the Institute.
4) We have also read, understood and accepted the code of conduct and the notification displayed on the general Notice
Board of the Institute and we shall take note of the communications put from time to time.
5) We have been explained clearly that the IEMT runs many educational Institutes with affiliation of different Universities
and many institutes which are study centers of various DEC and UGC approved Universities. We have filled up the
application forms after studying all the options.
6) All admissions offered by Institute of Engineering & Management Trust institutes are conditional, subject to the following
conditions :
i) All informations and declaration made in the application form and documents submitted as per rules are correct and true
to the best of our knowledge and belief.
ii) Admission to all degree courses are subject to registration by the respective University. In case of refusal of registration
of a student by the University concerned or in the event of withdrawal of affiliation, IEMT shall not be held liable for such
cases. IEMT will refund the entire fees paid without any deduction.
7) We have not paid any capitation fees for admission to IEMT institutes.

Signature of Guardian

Signature of student

Date :

Date :

FOR OFFICE USE ONLY

Interview taken by :
Comments :
Form checked by :

Fees deposited Rs.

Admission recommended by :
Admission approved by :

Receipt no. & date :

Counsellor :
Comments :

N.B.: All payments by DD in favour of Institute of Engineering & Management Trust payable at Kolkata.