Online Registration for Admission in IIMSHE Comunity College
Bhopal (M.P.) India

 

Please deposit an amount of INR 1100/- only as registration and form fee to our following bank account.

 

Bank Name : Dhanlaxmi Bank

Branch Name : Bharat Nagar, J.K. Road, A Sector, Indrapuri, Bhopal, Madhya Pradesh, India

Account Number : 022600100025444

Account Name : Institute of Industrial Management for Safety, Health & Environment (IIMSHE)

IFSC Code : DLXB0000226

 

After deposit please inform us through mail at our email ID : iimshe.safety@gmail.com with your deposit detail (Bank transaction ID, date of deposit etc.), online generated registration ID, name and course applied for.

 

Note: * Marked fields are mandatory

 

Course Applied for :

Gender :

*Name in Full :

Specify Category :

* Father's / Spouse Name :

Date Of Birth :

Nationality :

Domicile State :

* Address :
(In block letters)

* Mobile :

* E-Mail Address :

Deposit detail :

UTR No / Bank transaction ID :

 

 

Date of deposit :

 

 

Educational Qualification :

S.No.

Examination Passed

Degree Awarded

University / Board

Year of Passing/Award

Division

% of Marks/Grade

Subject Taken

1.

Post Graduation

2.

Graduation

3.

*HSSC(XII)

4.

*High School/HSC (X)

# Percent conversion of grade should be specified and the proof of conversion factor should be shown at the time of interview

 

References (Minimum Two) Name, Designation, Institution Address, Tel./Mob. No. and Email id of Referees:

* Reference (I) :

        Your contact since :           

* Reference (II) :

        Your contact since :           

Declaration:

 

I affirm that the information given in this application is true and correct. I also fully understand that if at any stage it is discovered that an attempt has been made by me to willfully conceal or misrepresent the facts, my application for admission may be summarily rejected.

 
   
 

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