Note: Please read the instructions and form carefully before filling it. Mandatory fields are marked with '*' next to the title. Please write N/A if a particular field is not applicable.

Type of Admission:*
Academic Year
 
Mode of Admission:*
Session:*
Center Code:*
 


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Programme Applied For:*
Specialization:*
Select Term:*

(for programme list see de.nimsuniversity.org)
 

Personal Information

Name :*

(based on the certificate of 10th examination)

Date of Birth:*
Age:*
Gender (M/F):* Category:*
Nationality:*
If others please specify:
Marital Status:*
Proof of Residence:* Email:*

Please enter your personal email id.


Correspondence Address:

  • Address Line 1 :*
  • Address Line 2 :
  • City :*
  • State :*
  • Pin(Zip) Code:*
  • Phone No :*
  • Mobile No :*

Check this box to copy same address below.

Permanent Address

  • Address Line 1 :*
  • Address Line 2 :
  • City :*
  • State :*
  • Pin(Zip) Code:*
  • Phone No :*
  • Mobile No :*

Check this box to copy correspondence address below.

Contact Details of Guardian

  • Guardian Name:*
  • Address Line 1 :*
  • Address Line 2 :
  • City :*
  • State :*
  • Pin(Zip) Code:*
  • Phone/Mobile No :*

Family Details

  Name Occupation Phone No Mobile No E-Mail Address
Father*
Mother*

Academic Information

Name of Qualifying Examination* Month & Year* Percentage*

Educational Qualification

Examination Stream

For example B.Sc maths/B.Tech/B.A/BRT

Name of the
School / College and
Board / University
Year of
passing
Subject Studied Marks Obtained Maximum Marks Percentage
10th*
12th
Graduation
Post Graduation
Other Educational
Qualifications

  • Awards and Achievements (if any) :
  • Participation in Extracurricular Activities :

Employment History

Work experience :
If yes then Total Experience
Years: Months: 

Name of Company Address Duration Designation Nature of Work Salary Drawn


Payment Mode:* Bank Name:* DD Number:*      Amount* DD Date:*
Rs

Declaration

I hereby certify and declare that the information given in the Application is complete and accurate to the best of my knowledge.
I understand and agree that misrepresentation or omission of facts will justify the denial of admission/cancellation/expulsion.
 I abide to all the terms & conditions of the University

Online admission is open only for Promotional Students/Learners