Online/ New Admission

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.

Course Information

Student Photograph Image should be less than 100kb
Course Type*
Proposed Class for Admission*
If You Want Hostel* :     Yes   No Hostel Category

Candidate Personal Information

Please Enter your Details based on the certificate of 10th examination

Full Name*   Date of birth*
Gender* Male Female   Category*
Marital Status*   Email*
Contact Number*      

Contact Information

→ Correspondance Address

→ Permanent Address (if same please check this)

Father's Name   Nationality
Street Address   Street Address
City   City
State   State
Pincode   Pincode

Contact Details of Guardian

Guardian Name   Contact Number

Educational Qualification

Examination Stream/ Specialization Board/University Name Year of Passing Roll Number of Marksheet Marks Obtained Percentage / Grade Marksheet Picture
10th*
12th
Graduation
Post Graduation
Other Qualifications

Fee Deposit Details

» Student can deposit Admission Fee as mentioned in prospectus by Cash in their Own City in any State Bank of India Branch.
» Bank Draft should be in favour of "IIMT MEDICAL COLLEGE AND HOSPITAL" payble at "AGRA".

Send your Bank Draft by registered speed post on the Address:

Ganesh Nagar, Lawyer's Colony, Near Khandari, Bye Pass Road Crossing, NH-2, Agra(U.P), Pin - 282005
Payment Mode*

Self Declaration

I hereby declare that the details furnished in the online admission form by me above are true, correct complete and to the best of my knowledge. The college has full right to reject/cancel my application/enrolment, If any type of information found incorrect or incomplete. I have read and understand the Rules & Regulations From the prospectus as well as, from the website also before joining the course at IIMT GROUP OF COLLEGES, AGRA and agree to abide by them. I also accept liability for payment of all fees as explained in this course and understand that any fee once paid to IIMT during the admission or afterwards, will not be refunded under any circumstances, except when the course is cancelled by IIMT GROUP OF COLLEGES.
I abide to all the terms & conditions of the College
  Signature of Applicant
Image should be less than 100kb
       
   
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