NIIT Imperia Common Application Form
Instructions    
 Name*     
 Date of Birth*(DD/MM/YYYY)  
 Gender* 
 PAN Card   Upload PAN Card     
(JPG/GIF/JPEG upto 100 kb)
 Nationality*  
Correspondence Address Permanent Address                                         Same as Correspondence Address
 Line 1*  Line 1
 Line 2*    Line 2
 City*  City
 (If Others)  (If Others)
 State*      State
 Pin code*     Pin Code
 Landline Number -      Landline Number -    
 Mobile*    
 Primary Email ID*
 Confirm Email ID*   
 Alternate Email Id
 Preferred Center*
 
 Source of Enquiry*
   
Examination Area Year of passing School / College Board/University Specialization %age CGPA Out of
XIIth/PUC *
Graduation *
Post Graduation
Any Other
* Candidate can either enter Percentage or CGPA. If CGPA is entered then the OUT OF field is required to be filled.
Occupation*
Industry*
Functional Area*
Total Period of Full time paid employment* Years Months
Describe your Work experience below, beginning from the most recent paid-job till space permits. (Atleast 1 detail is mandatory, maximum 7 allowed)*
Add Work Experience Details
 OrganizationFrom Date
(DD/MM/YYYY)
To Date
(DD/MM/YYYY)
Total Experience
(in months)
Designation  
1

Total Work Experience in months : 0
Are you an Industry Sponsored Candidate?*
Preferred Study Center*
Program Selection *
Test Date*
Preferred PAT(Program Aptitude Test) Location*
Preferred Venue*
Test Slot*
Application Fee*
The Application Fee payable is: Rs.
[Inclusive of GST]
Please indicate the preferred payment mode.
 
You need to complete a Statement of Purpose for each of the programs you have applied for. Your answer will be used to assess your suitability for the program. Typically, your answer should include your reasons for doing this program, how the program relates to your background and experience so far, what you wish to achieve after completing this program, etc.

Limit your answer to 2500 characters.
Statement of Purpose [SOP] can be reviewed by logging in to the portal through email id and date of Birth. You are requested to please review SOP for grammatical checks, through Transaction --> Fill Statement of Purpose and then click on SUBMIT
  

DECLARATION :

  • I have gone through the information bulletin and applicable Program Details including Eligibility requirements and instruction details. I declare that all information given and statements made in this application and also its accompanying attachments and enclosures are true to the best of my knowledge. I agree if any information or statement is found to be incorrect, my application and subsequent admission will automatically be cancelled and no money will be refunded. I am also aware that the institute(s) concerned or NIIT Imperia may reject my application without assigning reasons for the same. I am aware that all fees paid are non-refundable or non-transferable.
  • Select I Accept button to indicate that you understand that your personal data will be used in accordance with the Privacy Policy here. *

  •   
    To enable Submit Application button for submitting Application Form , please fill Program Details and Click on SAVE PROGRAM FORM.

     

    * Mandatory fields



    For further information: Call at 18001806060 (MTNL/BSNL)