Online Application - TAMRALIPTA INSTITUTE OF MANAGEMENT & TECHNOLOGY

Programme Applied For :-

BBA(H)BBA(H) in Hospital ManagementBCA(H)B.Sc(H) in BiotechnologyB.Sc(H) in MicrobiologyM.Sc in Computer Science

Student photo (max size 500kb)* :-

Qualification Details :-

Examination	Name of Institute	Name of Board / University / Council	Year of Passing	Subjects	Marks (%)
10 / Equi
10 + 2 / Equi
Graduation
Post Graduation

Date of Birth (as per board certificate)* :-

Gender* :-

MaleFemaleOthers

Blood Group :-

Nationality* :-

Category* :-

GeneralSCSTOBC

Religion* :-

Present Address* :-

Pin Code* :-

Student's Mob. No.* :-

Email ID* :-

Father's / Spouse Name* :-

Qualification* :-

Occupation* :-

Parent's / Guardian's Contact No.* :-

Parent's Annual Income* :-

Hostel facility required or not* :-

YesNo

Qualification* :-

Occupation* :-

Delcaration :- The perticulars are true to the best of my knowledge. I fully well understand that application is liable to be cancelled in case any discrepancy is found in the data submitted. I shall abide by the rules and regulations of the Tamralipta Institute of Management & Technology.

Parent's Signature with Date (max size 200kb)* :-

Student's Signature with Date (max size 200kb)* :-