Indian Institute of Gems & Jewellery, Mumbai (Varanasi Extension)

Admission Form
Form No : Date : Roll No :

Course : Batch: Start Date :

How did you come to know IIGJ Website If Others, Specify Passport
about IIGJ Advertisement Photograph
Industry
Internet
IIJS
Friend/Email/SMS
Brochure/ Pamphlet
Personal Information Section
Name of the student Last Name First Name Middle Name

Contact No.: Mail id:

Date of birth: Gender: Male Female
Citizen of:
Name of the Parent/ Last Name First Name Middle Name
Guardian

Profession
Contact No.: Mail id:
Address for
correspondence
City: District: State : Pin Code:
Permanent Address
City: District: State : Pin Code:
If Employed, Organization
details
Educational Qualification Degree/ College/University Class Year
Specialization

SSC Mark Sheet HSC Mark Sheet

Enclosures
Photo : Yes No Aadhar Card PAN Card
For Foreign Students Only VISA and Police Verification Papers:

Medical Certificate of Anti-Tetanus Injection Only for Jewellery Manufacturing Course:

Signature of the Candidate with Date:
For Office Use Only :
Signature of Admission Officer:

Account Bank Name Cheque/ DD No. Date Receipt No.

Department
Payment Details :
Note : Account Payee Cheque/ DD / Pay Order in favour of “Indian Institute of Gems & Jewellery”
Payable at Mumbai for the payment Admission Fees. Strictly NO CASH will be accepted.
Signature of Accounts Department

Indian Institute of Gems & Jewellery

Department Intimation Form
Name of the Student Roll No.

Course Type Degree / Diploma / Certificate Course Code

Faculty Name Batch No.

Email ID. Mob No.

Start Date End Date :

Signature of Accounts : Signature of Student Counsellor :

Undertaking Form
1. I undertake that it would be obligatory on my part to participate in all academic, co-curricular and extracurricular practice inclusive
of research, training, industrial visits, seminar, study tours, placements and other activities in our outside the Campus, organized /
arranged by IIGJ Mumbai of the fee and charges prescribed for the purpose or otherwise as deemed fit by the University from time
to time.
2. I shall maintain minimum 75% Attendance in both Theory and Practical in all subjects and submit all Assignments, projects, Portfolio
in time. If I am unable to comply with these norms, I understand that I shall not be allowed to appear for the End Semester/ Course
End examinations.
In Case I am unable to maintain 75% attendance then I am aware that my parents may be informed by email or sms regarding my
absenteeism.
3. Passing in all Tests and Examinations is mandatory to get a Certificate. Students have to submit leave application giving valid reasons
for absence from the classes, to the concerned HOD.
4. I shall ensure that my absence from classes for more than 10 days without prior information shall lead to cancellation of the
admission and would attract re-admission charges, as may be decided on case to case without any refund of fees.
5. I shall adhere to the prescribed Dress Code in the Institute and display ID card at all times on the campus.
6. I shall comply to the rules and regulations prescribed for the usages of Institute facilities and infrastructure viz. Library, Computer
Lab, Workshop, etc.
7. I shall undertake to inform the changes in Contact number or Address immediately to the Student Counselor /Reception Counter.
8. I shall not indulge in any unsocial, criminal or political activity, which is not conforming to the rules and regulations of the Institute.
9. I shall refrain from consumption of all tobacco products, alcohol, chewing of Gutkha, inside and within 100 yards of the Institute as
per directive of Division Bench of Chief Justice, Bombay High Court.
10. I understand that ragging in any form is strictly prohibited in accordance, as per directions of Honorable Supreme Court of India. I
shall ensure that if I am found indulging in any kind of ragging the Institute may initiate prescribed legal action against me or I may
be rusticated.
11. I shall comply with Institute policies regarding usage of personal laptop in the Institute premises and refrain from installing using or
copying any pirated software on personal laptop or Institute computers while in the Institute network.
12. I shall ensure thorough compliance to Software License agreement by not using pen drive in the Institute. As per Institute policy I
shall access my data through Google drive, Drop box or email.
Name of the Candidate Place: Date: Signature:
Name of the Parent/ guardian Place: Date: Signature:

Indian Institute of Gems & Jewellery

Placement Intimation Form

Name Roll No. :

Course Type Degree / Diploma / Certificate Course Title and Batch :

Mob No. & Email Id

Start Date End Date :

Type of Industry

Preferred Location

Signature of Student

For Office Use Only

Indian Institute of Gems & Jewellery

Alumni Association Member Registration Form

Registration no. Membership no.

Year of passing: Course:

Name:

Address:

Contact no. Mail id

Profession Working/ Entrepreneur / If other give details:
Other

Work address:

Name of parent Profession

Cheque no. Bank/ Branch

Date of cheque Signature of

Accountant

Signature of Alumni Date:

Signature of Alumni Incharge:

Indian Institute of Gems & Jewellery

Library Intimation Form

Name

Course Type Degree / Diploma / Certificate

Course Title and Batch

Mob No.

Start Date End Date :

Signature of Accounts : Signature of Student Counselor :