IEM GROUP OF EDUCATIONAL INSTITUTIONS

Application Form

Course Applied for:

Name (in block letters):

Father's Name:

Mother's Name:

Select a file:

Occupation:

Permanent Address:

Pin Code:

Guardian's Mob. No:

Mailing Address:

Date of Birth:

High School Roll No. / Board::

Whether you belong to: SC ST OBC GEN MINORITY

Academic & Professional Qualification : (Start with High School)

Instruction to the candidate

A) Admission to each course shall be made on the basis of UPTU/BTE Lucknow/ Dr. RML Awadh University rules Whichever is applicable.

B) Attest copies of the mark sheets of qualification.

C) Fee once deposited is not refundable under any circumstances.

D) Dispute if any will be subject to Lucknow jurisdiction.

Institute of Environment & Management, "Environment House", Alkapuri, Kursi Road, Lucknow - 226022
91 9450650965 | +91 9451949127
iem_lko@rediffmail.com