Online Application Form
The ICFAI University, Raipur
Campus-based Programs 2019

Admissions Office :
The ICFAI Univeresity,Raipur
NH-6, Raipur - Bhilai Road,
KM Stone 20 PO: Kumhari,
Dist: Durg - 490042, Chhattisgarh.
Phone No.:07415869445.
E-mail: admissions@iuraipur.edu.in
Website: www.iuraipur.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)

Aadhar Card No.

:

   

 
   3. PERSONAL DETAILS (use capitals only)
 

Date of Birth

:

Blood Group

:

Mobile

:

E-mail

:

Parent's Name

:

Parent's E-mail

:

Tel (Res)

:

 

Nationality

:

Mailing Address

:

City

:

State/UT

:

Pin

:

 
   4. ACADEMIC RECORD: SCHOOL/ COLLEGE

a.

Class

Name of the School/College

City

Board */ University

Group**

Medium of Instruction

Year of Passing

% of Marks

X

XII

Graduation

Others

* Indicate State Board/CBSE/ICSE etc.,
** Indicate PCM/Accounts/Commerce etc or Degree or branch of Diploma as applicable
.

b.

Name & Address of Institute last attended

:

 

City

:

State/UT

:

Pin

:

 
   5. 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)        Friends

News Paper Article         News paper/Magazine advertisements       Electronic Media (FM/TV)      Education Fairs   
   
Events of IUJ    Alumni/Students of IUJ   Faculty    Marketing Officer
   Others  
 
   6. WHY DO YOU WANT TO JOIN THE PROGRAM AT IUR? Describe briefly
 
 
   7. FAMILY BACKGROUND
 

a.

No. of Brothers :

No. of Sisters :

        

b. Parents Info

Father

Name

Qualifications

Occupation

Please Specify  :

Designation

Annual Salary/
Income

Organization

 

Mother

Name

Qualifications

Occupation

Please Specify  :

Designation

Annual Salary/
Income

Organization

 
   8 . MODE OF PAYMENT
 
Payment Mode
:
 
   9. DECLARATION
 

We hereby declare that the above mentioned information is true to the best of our knowledge and belief.

 
  I Agree