Admission Application Form (2017-2018) : (For Indian/NRI/PIO/OCI Candidates)
Admission Application Form (2017-2018) : (For Indian/NRI/PIO/OCI Candidates)
Admission Application Form (2017-2018) : (For Indian/NRI/PIO/OCI Candidates)
Candidate's Details
5. Name of the Candidate___________________________________________________________________________
(i) Contact Number____________________________________________________________________________
(ii) Email_____________________________________________________________________________________
6. Gender M F TG
7. Date of Birth D D MM Y Y Y Y
8. Place of Birth__________________________________________ 9. Domicile_____________________________
Parent's Details
13. Father's Name______________________________________________ Contact No.__________________________
14. Mother's Name_____________________________________________ Contact No._________________________
15. Email ________________________________________________________________________________________
Address Details
16. Residence Status City/Town Village
17. Corresponding Address___________________________________________________________________________
_____________________________________________________________________________________________
City/District________________________________ State _____________________ Pin Code
21. DD Details
DD/Pay Order Number____________________Dated_________Amount_______________
Bank Name & Branch________________________________________________________
DD/Pay order of Rs. 1000/- to be made in favour of "Treasurer, Integral University", payable at Lucknow
Miscellaneous Information
22. How did you get to know about Integral University
Newspaper Internet Radio Magazine
Friends Relative Univ. Website Hoardings
TV Other (Specify) ___________________________________________
23. Have you previously applied for admission to Integral University? Yes No
If Yes, Course previously applied for ___________________________________________
Were you selected Yes No
Declaration
I certify that the particulars given by me in this application form are true to the best of my knowledge & belief. I have
carefully read the Prospectus of Integral University & agree to abide by the terms & conditions mentioned therein.
________________ ________________________
Date Signature of the Candidate
Documents to be enclosed (As applicable for the opted program)
Mark Sheet & Certificate of High School (Std X) or equivalent examination.
Mark Sheet & Certificate of Intermediate (Std XII) or equivalent examination.
Mark Sheets of all years of Graduation & Degree. (for admission to post-graduate courses only)
Referred by (if any)
Name____________________________________________ Email Id__________________________________
Employee Code____________________________________ Contact No._______________________________