Indian Institute of Information Technology Design and Manufacturing Kancheepuram

IIITDM Kancheepuram, Chennai

Information for Admission to B.Tech and Dual Degree Programmes through DASA-2017 The candidates who got seat allotment under DASA-2017 process for admission into B.Tech/Dual Degree programme of IIITDM Kancheepuram, Chennai for the academic year 2017-18 are requested to report at IIITDM Kancheepuram between 21-July and 25-July for institute admission.

Reporting for admission during the mentioned period is must,

failing which the seat will be cancelled.

Orientation and Academic session will commence on 31-07-2017*. Hostel accommodation will be provided from 31-07-2017. *Note: Please follow the Institute website for any change in the date of commencement of academic session, which depends on JoSAA admissions Documents to be Produced for verificationOriginal Certificates to be produced by the candidate at the time of Admission

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Passport/Citizenship Card, PIO Card, OCI Card 1) For Indian Nationals (NRIs including CIWG) proof for 11th and 12th examination from

abroad. 2) For CIWG Category

1. Passport of parent working in gulf 2. Visa of parent working in gulf 3. Letter from company of parent working in gulf

3) For candidates from Nepal-Authentication of citizenship card 4) Proof for DOB 5) 10th mark sheet / certificate 6) 11th mark sheet / certificate 7) 12th mark sheet / certificate 8) School certificate (as per the format given in admission brochure) 9) If result is awaited, candidate has to produce late submission undertaking 10) Other relevant documents uploaded at the time of registration 11) One-set of self-attested xerox-copy of the above certificates 12) Proof for fee payments 13) Passport size photographs 3 Nos 14) Application forms and Medical certificate appended herewith

Fee to be PaidCandidates reporting for admission shall pay the balance fee in INR. The balance fee is Rs. 35075/- plus deficit amount if any. Mode of payment is online. Payment shall be made at the time of admission.

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Fee Details

I. Institute Fees

Particulars Fee Amount B.Tech / DD

A One time Fees 2500 B Semester Fees 4800+(Tuition fee)* C Deposits (Refundable) 2500 D Medical Insurance (per annum) 575 Total [A+B+C+D] 10375 * First semester Tuition fee will be transferred by DASA-HQ to Institute II. Hostel Fees E Deposits (Refundable) 2000 F Hostel Fees & Mess Charges per Semester* 22700 Total (E+F) 24700 * Includes approximate food expenses per semester * Under revision III. Deficit amount (if any)

Contact Details: General Information:

Office: 044-27476300 Admissions: 044-27476352 / 09841490805 Hostels: 044-27476349 / 09176010587

How to Reach IIITDM Kancheepuram: IIITDM Kancheepuram, Chennai is located near Kandigai on Vandalur-Kelambakkam road. Pre-paid / post-paid taxi is available from various places viz., Chennai airport, Chennai central railway station, etc. Infrastructure: IIITDM Kancheepuram is equipped with required infrastructure and is located at Melakottaiyur, off-Vandalur-Kelambakkam Road, Chennai – 600127. For more details visit: http://iiitdm.ac.in/Campus/Infrastructure.php Hostel Life: IIITDM Kancheepuram provides a good blend of academic, cultural, and social experience to all the students. For more details visit: http://iiitdm.ac.in/Campus/Hostel.php Sports: At IIITDM Kancheepuram, we provide facilities for students to experience “above and beyond” academic experience, to maintain their physical fitness and to excel as a bright student. For more details visit: http://iiitdm.ac.in/Campus/Sports.php Technical Club: The designers’ club aims to promote creativity and to increase the technical know-how and productivity of all the students of the college. For more details visit: http://iiitdm.ac.in/Campus/tClubs.php

At the time of admission, submit the filled-in forms attached herewith

Indian Institute of Information Technology Design & Manufacturing, Kancheepuram

***** APPLICATION FORM FOR ADMISSION TO BTECH/DUAL DEGREE PROGRAMME

(To be submitted by the students allotted to this Institute by DASA)

1. Application ID. 2. SAT Score 3. Passport No. 4. Nationality 5. Category: OP SC ST PH 6. Religion: ______________________________________________________ 7. Applicant’s Name: __________________________________________________ 8. Date of Birth: _____________________________ 9. Sex: ______________ 10. Parent’s/Guardian’s Name __________________________________________________________ 11. Parent’s/Guardian’s Occupation & Address_________________________________________________ 12. Permanent Address 13. Address for Communication ______________________________________ _____________________________________ ______________________________________ _____________________________________ ______________________________________ _____________________________________ City: __________________ PIN code: _________ City: __________________ PIN code: ______ Landline No: ___________________________ Landline No: __________________________ Mobile No: ____________________________ Mobile No: ___________________________ Email: __________________________________________________________________________ 14. Academic Qualifications

Examination School Board / University Year of Passing

Percentage of Marks

10th Class

10+2 Class/ Intermediate

15. Declaration: I hereby declare that the particulars stated above are true to the best of my knowledge and belief. In the event of suppression or distortion of any fact, I understand that my admission/degree acquired is liable to be cancellation. I shall abide by the rules and norms of the discipline of the Institute.

Left Thumb Impression Signature of the Candidate of the Candidate Place: ________________ Date: ________________ Countersignature of Parent/Guardian: _____________________________

Paste colour photo with white coloured

background Size of 51mm x 51

mm

OBC

IIITD&M KANCHEEPURAM (USE BOLD FULL CAPS LETTERS)

STUDENT DATA FORM

Name :

Roll No :

Date of Birth : Blood Group :

Religion :

Parent’s/Guardian’s Name :

Parent’s/Guardian’s Occupation & Address :

Mobile Number Student (if any) :

Parents :

Email-Id Student :

Parents :

Permanent Address :

Landline Number :

Hostel :

Local Contact Person :

Name & Address :

Phone Number :

EDUCATION (From 10th onwards)

Duration School/College Course (10th

, +2, HSC, etc.,)

SKILLS

Specific Academic Interests :

Softwares /Prof Languages Known :

Designing Tools :

Other Tools:

EXTRA CURRICULAR / CO-CURRICULAR ACTIVITIES (NSS, ROTRACT, ETC.,)*

SPORTS INTEREST / ACHIEVEMENTS*

OTHER ACHIEVEMENTS, AWARDS, RESPONSIBILITIES HELD

*Indicate if you have represented district/ state/ national level

Signature of the student

*Reg. No:

HOSTEL OFFICE Indian Institute of Information Technology Design and Manufacturing (IIITD&M)

Kancheepuram Melakottaiyur, Vandalur – Keelambakkam Road, Chennai – 600 127

HOSTEL REGISTRATION FORM Hostel Name: *Room

No:

Paste colour photo with white coloured background

Size of 51mm x 51 mm

FULL NAME (Capitals)

Father/Spouse NAME

Gender: DOB:

Nationality: Age:

Program: B.Tech/Dual Degree/ M.Des/ PhD/ Others

*Roll Number:

Email ID: Date of Join:

Permanent Address: Local Guardian’s Address:

NAME:

City: City:

State: State:

Pin Code: Pin Code:

Ph. No: (Land line)

Ph. No: (Land line)

Mob: Mob:

Email: Email:

Major illness: (if any)

* to be filled by the office DECLARATION

I, _________________________________ Son / Daughter of _________________________________ joining B.Tech/DD/M. Des/Ph. D program hereby declare that I will follow hostel rules and regulations and will not use any powered vehicle inside the Institute premises during my stay.

Student Signature Parent / Guardian Signature

For office use only

Hostel Office Warden

POSSESSION AND USE OF POWER VEHICLE IN THE IIITD&M KANCHEEPURAM CAMPUS

DECLARATION I,______________________________________________________________ Son

/ Daughter of __________________________________________________joining

B.Tech/M.Tech/M. Des/Ph. D ________________________________ program

hereby declare that I will not use any powered vehicles inside the IIITDM

Kancheepuram Campus during my stay as student of IIITDM Kancheepuram. Date: Signature of Parent/Guardian Signature of the Student

INDIAN INSTITUTE OF INFORMATION TECHNOLOGY DESIGN & MANUFACTURING (IIITD&M) KANCHEEPURAM

Chennai

LOCAL GUARDIAN IN CHENNAI/TAMIL NADU Name :_______________________________________________________________ Relationship :_______________________________________________________________ Address :_______________________________________________________________

:_______________________________________________________________ Contact No :_______________________________________________________________ Email Id :_______________________________________________________________