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IMS Goa ::Pre-Sea Training Course In Marine Engineering

http://www.imsgoa.org/form/me_form.html

Society for Industrial & Technical Education of Goa's INSTITUTE OF MARITIME STUDIES ISBT COMPLEX, BOGDA, VASCO-DA-GAMA,GOA- 403 802. Email: admissionsimsgoa@gmail.com, Ph- 0832-2520986/2524063

INSTRUCTIONS

APPLICATION FORM

INFORMATION ABOUT COURSES


A. ADMISSION: Through Written/Online Entrance Exam. followed by Interviews, Psychometric Test, Medical Test. An amount of Rs.1500/- for GME and DME candidates is to be paid by the candidate towards online/entrance exam and Psychometric test fee. (An amount of Rs.6500/- for Medical and Admission fee will have to be paid by candidates short listed after interviews) B. DETAILS OF COURSE: ( for more details visit our website: www.imsgoa.org) Sr.Nos. I Details ELIGIBILITY Diploma Entry Course Degree Entry Course

Educational Qualification

Diploma in Mechanical/ Shipbuilding B.E. Mechanical, Mechanical & / Electrical /Electrical & Electronics/ Marine Engineering automation or

Naval Architecture

b c d e

Minimum Marks Maximum Age Marks in English Eye Sight

50% Age not exceeding 28yrs. on 02nd December Minimum 50% in X or XII or Diploma 6/6 or 6/12 in each eye or 6/18 in one eye and 6/9 in other eye without glasses WITH NO COLOUR BLINDNESS by Ishihara chart. 40 2 Years 1st December every year Rs. 4,89,000/- + Rs. 10,000/in two yearly installments. Rs. 3,57,000/- + Rs. 10,000/on ADMISSION 80 1 year

f II III IV

No. of seats COURSE DURATION COURSE COMMENCES ON FEE

Caution money (refundable). Payable

Caution money (refundable) Payable

FEE INCLUDES

Inclusive of course fee, boarding & lodging, uniforms, uniforms shoes, insurance, training and assessment record book, training manual, auxiliary courses, stationery, CDC, INDos registration, IME (I) Membership etc..

boiler suits, safety shoes, library, laboratory charges, group accidental

VI

BOARDING & LODGING

Compulsorily Residential

VII

SUBJECTS FOR ENTRANCE EXAM.

Engineering Knowledge General Knowledge English

Total 200

marks

Engineering Knowledge General Knowledge

Total 200

marks

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IMS Goa ::Pre-Sea Training Course In Marine Engineering

http://www.imsgoa.org/form/me_form.html

Applied Mechanics Heat Engines Mathematics

Duration 2.5 hrs

Duration 2 hrs

Engineering Drawing PSYCHOMETRIC EVALUATION 1 HOUR APPROXIMATELY PSYCHOMETRIC EVALUATION 1 HOUR APPROXIMATELY

I. SELECTION PROCEDURE: 1. All expenses incurred by way of travelling, boarding, lodging etc. for the purpose of this selection, will have to be borne by the candidate. 2. Any candidate found using unfair means or having made false representations will be disqualified. 3. It has been brought to our notice that some agents / persons are charging a fee from the prospective candidates to facilitate selection at candidates.

IMS, Goa. Please be advised that we have NO such agreement with any agents nor any individual or Company, for the purpose of selection of

4. Medical standards in this line of work are very strict. Furthermore the nature of work involved demands a tough constitution and sailing on merchant ships for upto 10 months at a time. If the candidates have any doubts about meeting these requirements, they are advised to reconsider their decision to join this field.

II. RESERVED SEATS: A total of 8 seats in GME and DME Batch are reserved for sons of employees of the Organizations providing training facilities to IMS. These seats are allotted as per merit list drawn for the candidates under this category and does not involve any capitation fee. III. INSURANCE AND INDEMNITY: a. In view of the training being given in Industrial workshops, Shipyards and Training Vessels the Institute provides accident Insurance policy

for all. The Institute also arranges Mediclaim Policy for each Cadet at his expense, for a value of Rs.50,000/- for the period of training. The premium for this policy will be intimated to the Cadet for recovery at a later date. However it is advisable that the cadets take their own life insurance policies.

b. Notwithstanding above provisions, the Cadet and his/her parent/guardian shall sign a declaration indemnifying the INSTITUTE against any claim arising during the tenure of training.

IV. HOSTEL: 1. Hostel facilities for cadets include:

- Rooms ( on triple sharing basis) for studying and sleeping.

- Cadets Mess for all meals ( No meals are allowed to be taken in room). - Grounds / playing fields for outdoor games.

- Recreation rooms for playing indoor games, viewing T.V. and Internet station. 2. Hostel Warden is in-charge of the hostel and is available round the clock. not to request for night offs or additional liberty for any reason.

3. Liberty to go out is given only on Saturday evenings and Sundays. Night offs are permitted only once a month. Parents/Cadets are advised

V. ISSUE OF CDC: The INSTITUTE has to apply to the Shipping Master, Mumbai for issuing the CDC for each Cadet. The fee for this as charged by Shipping Master is Rs.500/-, which is included in I term fee. VI. ISSUE OF INDos No.: The INSTITUTE has to obtain INDos No. ( Indian National Database of Seafarers) for all Cadets on joining training INSTITUTE. The fee of Rs.1200/charged for this registration is included in I term fee. VII. AUXILIARY COURSES: Satisfactory completion of courses in Fire Fighting, First Aid, Proficiency in Survival Craft, Personal Safety and Social Responsibility, is the

requirement of the STCW 95 Convention, and hence is made compulsory by Directorate General of Shipping, Govt. of India. These courses are not conducted in the INSTITUTE. However, the INSTITUTE will arrange for these courses for its Cadets, at an appropriate training centre.The fee for these courses in included in first term fee.

These courses are of two weeks durations and form a part of the training programme being conducted by the INSTITUTE. No refund of fee, partly or fully, shall be made, if the cadet has already done these courses, elsewhere, before joining the INSTITUTE. VIII. PLACEMENT : IMS Goa has arrangement with following Shipping Companies for placement. The Companies select the candidates at the time of admission itself 1. M/s. Wilhelmsen Ship Management, (formerly known as Barber Ship Management.) 2. M/s. Anglo Eastern Ship Management

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IMS Goa ::Pre-Sea Training Course In Marine Engineering

http://www.imsgoa.org/form/me_form.html

3. M/s. V Ships

4. M/s. Tanker Pacific Management India Note:Placement for all successful candidates is assured. IX. PASSPORT: Selected candidates are required to have a valid Indian Passport at the time of course commencement. Those who do not hold an Indian Passport, should immediately apply for the same and submit 5 copies to the office on or before 01st December. 5. M/s. Geden Lines

IMPORTANT INFORMATION (FOR DEGREE ENTRY)


a. Name of the Course : Pre-sea Training in Marine Engineering for Graduate holders. b. Duration : One year c. No. of Seats : 80 d. Course Starts : 1st December, every year.

I. ELIGIBILITY FOR ADMISSION b. Qualification : B.E. ( Mechanical,Mechanical & automation, Naval Architecture ) with minimum 50% marks in aggregate of all the semesters c. Age : Age not exceeding 28 years on 02nd December from an AICTE approved Institution. a. Nationality : Indian

d. English : Minimum 50% marks in English in Std. X or XII. colour blindness.

e. Eye Sight : 6/6 or 6/12 in each eye or 6/18 in one eye and 6/9 in the better eye. Normal colour vision (tested by Ishihara test chart ) and no f. Medical Fitness : Medically fit for sea service as per DGS rules. NOTE:

b. All correspondence at selection stage will be done on e-mail.

a. Please do not apply, if you do not satisfy above eligibility criteria. c. All applicants must have an e-mail id and mention the same in the application form. disqualified immediately and not given chance to correct the eye sight by surgery.

d. Candidates are advised to check their eyesight to ensure it meets requirements as specified above. Candidate found deficient will be

II. SELECTION PROCEDURE:

1. On receipt of applications, and the draft of Rs. 1500/- eligible candidates will be sent Hall Ticket by e-mail only. 3. The details of the test centres will be mentioned in the Hall ticket.

2. Candidate is required to affix his photo on the Hall Ticket and bring it with him / her to exam. centre for Online test. 4. The list of Candidates shortlisted for interview, along with interview schedule will be displayed on www.imsgoa.org. The interviews will be 5. Names of the candidates selected in the interviews and also those placed in waitlist will be put up at the Institute, as per admission schedule. 6. All candidates selected for Interview must bring with them a Demand Draft of Rs. 6,500/- drawn in favour of "The Director, Institute of 7. The selected and waitlisted candidates will have to deposit a draft of Rs.6,500/-, before verification of certificates. who fails in Medicals. Maritime Studies" payable at Vasco Da Gama (Goa) towards Admission + Medical fee, in anticipation of being selected. held at the Institute at Goa, on the dates mentioned in Admission schedule.

8. Draft will be returned to waitlist Candidate not called for selection / medical. An amount of Rs. 3,000/- will be refunded to the Candidate 9. Candidates who are awaiting final semester results may also apply. However, they will be required to produce the Degree Certificate 10. One set of self attested photocopies of following Certificates is to be brought by the candidateat the time of certificate verificationalong with the originals. i. Passing Certificate of Std. X or XII , showing date of birth. along with mark sheet at the time of interview.

iii. Provisional / Degree Certificate of B.E. (Mechanical/ Naval Architecture) issued by the University (Certificate issued by College is not iv. Marksheets of all semesters of B.E. acceptable)

ii. Marksheet of X and XII / Diploma / Degree exam.

vii. Candidates who have appeared for the qualifying examination and awaiting results should attach a certificate from the appropriate viii. Proof of Work Experience, if any. authority to that effect.

vi. Certificates for any additional courses done, extra curricular activities like NSS / NCC/ Scouts etc.

v. Bonafide student and AICTE approval Certificate in the format available on IMS,Goa website.

Certificates of only selected candidates will be verified. It is the candidates responsibility to ensure his eligibility as per details given above, 11. Candidates whose applications are received after 10th August may not be issued admit cards due to shortage of time. Such candidates are requested to report to the examination centres of their choice along with two copies of their photograph. and also fill in true and correct information in the application form.

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IMS Goa ::Pre-Sea Training Course In Marine Engineering

http://www.imsgoa.org/form/me_form.html

III. SYLLABUS FOR ONLINE TEST: (MAX 2 HRS.) a. Engineering Knowledge Basic General Engineering Knowledge, Electricity, Heat Engines, Mechanics & Theory of Machines, Hydraulics, Electronics, Strength of Materials, Refrigeration & Air Conditioning, as covered in degree syllabus.

b. Mechanical Aptitude, Abstract Reasoning. c. General Knowledge, English

IV. FEE DETAILS (AT IMS, GOA) :

PAYMENT SCHEDULE: Pay on or before 20th October Advance fees (Non-Refundable) 50,000.00

FEE Tution Fees Pay on or before Hostel Charges STUDENT DEVELOPMENT CHARGES 1,00,000.00 97,000.00 1,10,000.00

5th November

3,17,000.00

Stationery, Safety Courses, TAR Books, Examinations, INDos registration, CDC,

Uniform, Text Books

IME(I) Membership, Library etc.

and Workshop Consumables

Caution Money Deposit ( course)

Refundable at the end of

10,000.00

TOTAL AMOUNT PAYABLE REFUNDABLE ( Caution Money ) NET FEE Note: In case, a candidate withdraws from the training, the fee paid will not be refunded to him.

3,67,000.00 10,000.00 3,57,000.00

Candidate desirous of obtaining educational loan from Bank may approach Bank of India or State Bank of India, Vasco Branch. It is advisable that they open an account in that Bank, before applying for loan. be eligible for any refund of fees. If a candidateafterjoiningthis training course withdraws on his own from the training or is expelled on disciplinary ground, he shall not Penalty @ Rs.50/- per day for late payment of fee will be charged as per the rules laid down by the INSTITUTE. Late payment with penalty is limited to a period of 15 days. After expiry of 15 days, heavier penalty may be imposed or the candidate may be expelled from training as per discretion of the Director. In unavoidable circumstances, fee may be revised during training, and the difference will be payable at that time.

ADDITIONAL WEIGHTAGE FOR FINAL SELECTION:-

Passed XII or Degree from Goa university. Percentage of marks in XII / Diploma Work Experience from 3 months onwards. NCC/Scout.

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IMS Goa ::Pre-Sea Training Course In Marine Engineering

http://www.imsgoa.org/form/me_form.html

CLASS IV PART A :
Candidates are exempted from Class IV Part A examination conducted by Mercantile Marine Dept., Govt. of India to become eligible for joining ship as Engineer. Admission Schedule: 1 2 Last Date of Receipt of Applications. Online Entrance Exam. Online Psychometric Test 10th August 01st August 31st August 7th to

List of candidates selected for Interview

September 23rd to 26th am)

Interviews of the short listed candidates at the Institute.

September( 9.00

List of candidates short listedforMedical Test, fee payment

Measurementof uniformsand Certificate Verification, fee, Total

of Admission Process , Medical Test

27th September ( 11.00 a.m.)

Rs.6,500/-. 6 Medical test of selected candidates 27th to 30th September

(Candidates can leave after Medical Test) Final Result (Put up on Website) Last date of Acceptance of Admission & Advance Fee of Rs.50,000/-

7 8

08th October

20th October

Last date for payment of first year fees.

05th November

10 Course

commencement at 09.00 a.m.

01st December

N.B.: Above dates are subject to change. Please check the website to confirm the dates once again in August.

IMPORTANT INFORMATION (FOR DIPLOMA ENTRY)


b. Duration : Two Years c. No. of Seats : 40 a. Name of the course : Pre sea Training in Marine Engineering for Diploma holders.

d. Course starts : 1st December , every year. I. ELIGIBILITY

1. Nationality : Indian

2. Qualification : Diploma (Mechanical / Electrical /Electrical & Electronics/ Shipbuilding / Marine Engineering) with minimum 50% mark in 3. Age : Age not exceeding 28 years on 02nd December. aggregate of all the semesters from an AICTE approved Institution.

4. English : Minimum 50% marks in English in Std. X or XII or Communication Skill I & II in Diploma. colour blindness.

5. Eye Sight : 6/6 or 6/12 in each eye or 6/18 in one eye and 6/9 in the better eye. Normal colour vision (tested by Ishihara test chart ) and no 6. Medical Fitness : Medically fit for sea service as per DGS rules.

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IMS Goa ::Pre-Sea Training Course In Marine Engineering

http://www.imsgoa.org/form/me_form.html

NOTE:

b. All correspondence at selection stage will be done on e-mail.

a. Please do not apply, if you do not satisfy above eligibility criteria. c. All applicants must have an e-mail id and mention the same in the Application Form. disqualified immediately and not given chance to correct the eye sight by Surgery.

d. Candidates are advised to check their eyesight to ensure it meets requirements as specified above. Candidate found deficient will be

II. SELECTION PROCEDURE:

1. On receipt of applications and demand draft of Rs 1500/-, eligible candidates will be sent admit card by e-mail only. centre will be mentioned in the admit card.

2. Candidate is required to affix his photo on the admit card and bring it with him/her to exam. centre for written test. The address of the test 3. Written test for all candidates will be held at Goa, as per admission schedule. held at the Institute in Goa, on the dates mentioned in Admission schedule. schedule.

4. The list of Candidates shortlisted for interview, along with interview schedule will be displayed on www.imsgoa.org. The interviews will be 5. Names of the candidates selected in the interviews and also those placed in waitlist will be put up at the Interview centre, as per admission 6. All candidates selected for Interview must bring with them a Demand Draft of Rs. 6,500/- drawn in favour of "The Director, Institute of 7. The selected and waitlisted candidates will have to deposit a draft of Rs.6,500/-, before verification of certificates. who fails in Medicals. Maritime Studies" payable at Vasco Da Gama (Goa) towards Admission + Medical fee, in anticipation of being selected.

8. Draft will be returned to waitlist Candidate not called for selection / medical. An amount of Rs. 3,000/- will be refunded to the Candidate 9. Candidates who are awaiting final semester results may also apply. However, they will be required to produce the Diploma Certificate along 10. One set of self attested photocopies of following Certificates is to be brought with you at the time of certificate verification along with the originals. i. Passing Certificate of Std. X or XII , showing date of birth. with mark sheet at the time of interview.

iii. Provisional/Diploma passing Certificate( Mechanical/Electrical/Electrical & Electronics/ Shipbuilding/Marine Engineering) issued by iv. Marksheets of all semesters of Diploma. the Technical Board (Certificate issued by College is not acceptable)

ii. Marksheet of X and XII exam.

vii. Candidates who have appeared for the qualifying examination and awaiting results should attach a certificate from the appropriate viii. Proof of Work Experience, if any. Certificates of only selected candidates will be verified. It is the candidates responsibility to ensure his eligibility as per details given above, and also fill in true and correct information in the application form.. III. SYLLABUS FOR WRITTEN TEST: (2.5 HRS. DURATION) Paper I 100 marks Duration 1.5 hrs. Type of Questions Descriptive, numericals etc. authority to that effect.

vi. Certificates for any additional courses done, extra curricular activities like / NSS / NCC/ Scouts etc.

v. Bonafide student and AICTE approval Certificate in the format available on IMS,Goa website.

Applied Mechanics 25 marks Heat Engines / Thermodynamics 25 marks Mathematics 25 marks Machine Drawing 25 marks Questions papers will have numerical. For drawing paper, two sectioned views i.e front elevation and side view / plan will have to be drawn. Candidates are required to bring their Instrument box containing pencils, compass, set square etc. Paper II 100 marks Duration - 1 hr. for above papers will be set from the topics covered in Diploma Course in the Polytechnic. Applied Mechanics / Heat Engines

Type of Questions Objective type (for section A & B)

1. SECTION : A- 50 marks: Engineering Knowledge - Fill in the blanks

- Objective type questions ( multiple choice) ( Negative marking for wrong answer) - Questions requiring very brief description SYLLABUS

- Questions will be set from very basics of following topics, which have been covered in Diploma Course in the Polytechnic:its systems and maintenance.

- Applied Physics, Applied Mechanics, Materials, Strength of Materials, NDT Tests, Power Engineering, Fundamental of Refrigeration, Diesel Engines, - Electricity, AC Fundamentals, Basic AC/DC machines, simple electrical circuits.

- Workshop Practices, measuring instruments, welding, soldering, brazing processes etc. 2. SECTION B- 25 Marks

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IMS Goa ::Pre-Sea Training Course In Marine Engineering

http://www.imsgoa.org/form/me_form.html

General Knowledge, Mental Ability Tests

a. General Knowledge : Current Events, Important Events from History, Science and Technology, Sports, Inventions and Discoveries, Geography, Awards, Pollution Prevention, Environment Protection, Indian Constitution, Brain Teasers, etc. b. Mental Ability / Tests of Reasoning. 3. SECTION C- 25 Marks a) English b) Essay & Letter Writing. Use of correct Grammar ability to write good English. FEE DETAILS: PAYMENT SCHEDULE: Pay on or before Advance fees 27th September Amount 50,000/Total 50,000/-

(Non-Refundable)

BALANCE FEE Pay on or before 20th October FIRST YEAR

Tution Fees Hostel Charges STUDENT

1,35,000/97,000/85,000/-

3,27,000/-

DEVELOPMENT CHARGES

Uniform, Text Books Stationery, Safety Courses, TAR Books, registration, CDC,

Examinations, INDos IME(I) Membership, Consumables etc.

Library and Workshop

Caution Money

Deposit( Refundable

10,000/-

at the end of course) BALANCE FEE Hostel Charges STUDENT 97,000/25,000/1,22,000/-

Pay on or before 17th October

SECOND YEAR

DEVELOPMENT CHARGES

AS ABOVE. Total Refundable Caution Money Net Fee Note: In case, a candidate withdraws from the training, the fee paid will not be refunded to him. Incase the fee is revised during the course duration the candidate will have to pay revised fees for the second year. Candidate desirous of obtaining educational loan from Bank may approach Bank of India/or State Bank Of India Vasco Branch. It is advisable that they open an account in that Bank, before applying for loan. not be eligible for any refund of fees. If a candidate after joining this training course withdraws on his own from the training or is expelled on disciplinary ground, he shall Penalty @ Rs.50/- per day for late payment of fee will be charged as per the rules laid down by the INSTITUTE. Late payment with penalty is 4,99,000/10,000/4,89,000/-

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IMS Goa ::Pre-Sea Training Course In Marine Engineering

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limited to a period of 15 days. After expiry of 15 days, heavier penalty may be imposed or the candidate may be expelled from training as per discretion of the Director. ADDITIONAL WEIGHTAGE FOR FINAL SELECTION:Passed X ,XII or Diploma from Goa Board. Candidates with XII Std. Work Experience from 3 months onwards. NCC/Scout. Diploma in Shipbuilding Engineering. Candidates are required to pass Class IV Part A examination conducted by Mercantile Marine Dept., Govt. of India to become eligible for joining ship as Engineer. ADMISSION SCHEDULE:

1 2

Last Date of Receipt of Applications. oNLINE Entrance Exam. Knowledge

10 August 1Oth August to 17th August

Paper I -Engineering Knowledge, English, General Psychometric Test.

3 4

List of candidates selected for Interview Interviews of the short listed candidates at the Institute.

20th August, 3rd to 5th September ( 9.00 am)

List of candidates short listedforMedical Test, Measurementof uniformsand Certificate Verification, Process , Medical Test fee, Total fee payment of Admission 6th September ( 11.00 a.m.)

Rs.6,500/-. 6th 7th

Medical test of selected candidates

& 8th September

7 8

Final Result (Displayed on Website) Last date of Acceptance of Admission& Advance Fee of Rs.50,000/- .

16th September 4.00PM 30th September

9 10

Last date for payment of First year Coursecommencement

fee.

20th October 01st December

at 09.00 a.m.

N.B.: Above dates are subject to change. Please check the website to confirm the dates once again in August.

ANNEX - 1
(TO BE TYPED ON THE COLLEGE / INSTITUTE LETTER HEAD & SUBMITTED AT THE TIME OF CERTIFICATE VERIFICATION) TO WHOMSOEVER IT MAY CONCERN

This is to certify that Mr./Ms________________________________________ son / daughter of Shri._______________________________ was a bonafide student of this College / Institute during the period ________________ to_________________. He / She has successfully passed the Diploma / Degree Examination in stream/branch ____________________________ held in the month of _________________________, and was placed in ____________________Class. His / her Registration No. was _____________________. His/ her conduct and character were ________________________________ throughout his / her stay in this College / Institute.

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IMS Goa ::Pre-Sea Training Course In Marine Engineering

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Further certified that the said course and the College/ Institute is approved by All India Council for Technical Education (AICTE), New Delhi vide their letter No. ____________________________________ dated ____________________ and the validity of the AICTE approval covers the entire duration of the Diploma / Degree course that the candidate attended.

Dated:______________ ( PRINCIPALS SIGNATURE) WITH OFFICE SEAL

Note: This certificate is acceptable for admission only if signed by Principal/Director/ Registrar of the Institute / College with the appropriate office seal.

APPLICATION FORM FOR ADMISSION TO PRE-SEA TRAINING COURSE IN MARINE ENGINEERING

*means Mandatory Fields


DD Details

*
DD No * Amount* Bank* Date*

Note: A Demand Draft of Rs 1500/- for GME and DME candidates, drawn in favour of "The Director, Institute name at the back of demand draft.

of Maritime Studies" Payable at Vasco Da Gama (Goa) to be sent at IMS address immediately. Please write your

Select Which Is Applicable

GRADUATE ENTRY

DIPLOMA ENTRY

Full Name Of The Applicant

First Name

Middle Name*

Last Name*

Parent's Details
Father's Name* Father's Occupation* Mother's Name* Annual Income of Parents*

Present Mailing Address


House No Village/PO/City* District* State* Email ID Select Street/Ward /Location Pincode* Tel No.with STD code:*

Mobile No.

Alternate Email ID

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IMS Goa ::Pre-Sea Training Course In Marine Engineering

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Personal Details
Date of Birth

(dd-mm-yyy)

- Day -

- Month -

- Year -

Gender

* *

Male

Female

Age( as on 2nd Dec.,13)

- Years - Yrs

- Month - Months

Height ( in cms): Place of Birth (State)*

Weight ( in Kgs):

Place of Birth (City)*

Nationality

Marital Status*

Single

Married

Any close relative working in Merchant Navy Relationship

Yes

No Working As

Educational Attainments
Overall Percentage of Marks Class X* School/College* Class XII/Diploma(For Board* Year of passing* Board - Select Year -

Degree Holders) School/College % of Marks in English Class X* Diploma FOR DIPLOMA CANDIDATES Mathematics Applied Mechanics

Year of passing

- Select Year -

Class XII Degree

Thermodynamics

Percentage marks of all semesters/ of semesters result is known: I II III Degree / Diploma (if yearly fill in II / IV / VI / VIII) IV V VI VII VIII Aggregate

NOTE: If result is awaited for any semester, pl. write RA under that. Candidate must fill in the rest of the boxes. Aggregate percentage should be of the available results. Please enter NA for semesters not part of Diploma Course. Stream: Degree / Diploma in* Month/Year of passing/appeared: * - Select Stream -

Engineering

- Select Month - / - Select Year -

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College/Institute Information
Name of College / Polytechnic:

*
Yes Yes No No

Whether College / Polytechnic AICTE Approved* If No is it a deemed Univerisity (Yes/No) Name & Address of University / Technical Board: (Degree / Diploma)*

Other Information
(All attainments to be supported by Documents at the time of Document Verification) Total Work Experience: NCC /NSS / SCOUTS - Years - Yrs Yes No

- Month - Months

Last Designation:

Submit

Reset

IMSGOA. All Rights Reserved.

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