APPLICATION FORM

Admission for the year 2025

Application Fees Rs.500/- Payment Method : Online (UPI/Bank Transfer) For Assistance contact : 8547610005,04712365559 or Email to : ildm.revenue@gmail.com

*marked fields are mandatory

Upload your recent photograph:*

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Format : png/jpeg/jpg

Full Name*

Date of Birth*

Age

Nationality*

State*

Religion*

Community*

Caste*

Gender*

MALE
FEMALE
OTHER

Permanent Address*

House Name/Number

Street

District

Post Office

Pincode

Communication Address*

same as above

House Name/Number

Street

District

Post Office

Pincode

Contact Information

STD Code

Telephone

Mobile Phone*

+91

Email*

Alternate Email*

Parent/Gaurdian Details

Parent/Guardian Name*

Occupation

Official Address

Pincode

STD Code

Telephone

Mobile Phone*

+91

Email*

Annual Income (Rs)*

Qualification*

Qualification	BSC BCOM BA BBA B.Tech Other
Branch/Subject
University
Month & Year of passing

Marks / Grades secured in qualifying exam*

SI	Semester No	Marks Secured / SGPA	Max. Marks	Action
1

Grand Total / CGPA
Percentage of Marks Secured(Aggregate)	%

Whether written CMAT/KMAT/CAT?*

Details of CMAT/KMAT/CAT

Exam Name	Register Number	Composite Score	Date of Test(dd-mm-yyyy)

Certificates

(Format : PDF,Max.Filesize:3MB)

SSLC*
PLUS TWO*
Awaiting Degree Result?*	YES NO
DEGREE
KMAT/CMAT/CAT SCORE CARD
Degree from outside Kerala?* If yes upload migration certicate ( can be produce before Admission)	YES NO
MIGRATION CERTIFICATE
INCOME CERTIFICATE
COMMUNITY CERTIFICATE /EWS
EQUIVALENCY CERTIFICATE

Upload your Signature:*

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Format : png/jpeg/jpg

Payment Receipt*

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I hereby declare that information furnished above is true and correct