iKollege:Triesten Technologies

Office of Hostel Management - IIT Madras

STUDENT REGISTRATION FORM

Instructions :

Fill all the mandatory fields.
Registration form will get enabled only when Institute given application number and Student ID is entered correctly.
Filling the Roll Number and Application Number is mandatory fields. Whatever you have (Roll No or Application No), please filled it in both fields.
Candidate should have the following for registration.
Photo of the candidate (Dimension of photo 300 x 700, image size less than 2MB)
Digital signature of candidate and parent (size less than 2 MB)
Candidate should read and accept the hostels rules and regulation and other forms before registration.
Once student completed all steps a PDF will generated. Take a print out of the PDF and submit it in the time of hostel admission.
After this, a link to hostel fees payment will be displayed to pay the fees.

Upload Documents :

Student Photo :

Student Signature :

Parent Signature :

Parent Name:

STUDENT REGISTRATION FORM

UNDERTAKING FORM

Click here to read the Undertaking Form

Click here to read the Hostel rules and regulations

Click here to read the Vehicle rules and regulations

Student Details :

Information

Filling the Roll Number and Application Number is mandatory fields. Whatever you have (Roll No or Application No), please filled it in both fields.

Roll Number : Example:AE10D010

Please Fill the Roll Number

Application No :

Please Fill the Application Number

Student Name :*

DOB :*

Please Fill the Date Of Birth

Mobile Number :*

Please Fill the Mobile Number

Gender :*

Male

Female

Please Choose an item in the List

Blood Group: *

Aadhar Number :

PAN Number :

Categories :*

OBC

General

SC/ST

Please Choose an item in the List

Mess Preference :*

Address :*

Please fill the Address

Any Other Information :

Faculty Name:*

Faculty Contact No:

Family Details :

No.of.Brother(s) No.of.Sister(s)

Name

Please fill the Name

Relation

Please Select an Relation in the List

Age

Please fill the Age

Email

Please fill the Email

Occupation

Please fill the Occupation

Mobile No

Please fill the Number

Income/Yr

Please fill the Income

Name

Please fill the Name

Relation

Please Select an Relation in the List

Age

Please fill the Age

Email

Please fill the Email

Occupation

Please fill the Occupation

Mobile No

Please fill the Number

Income/Yr

Please fill the Income

Local Guardian if Any:

Yes

Name of the Guardian :*

Please Fill the Guardian Name

Email :*

Please Fill the Guardian Email

Mobile Number :*

Please Fill the Guardian Mobile Number

Address :*

Please Fill the Guardian Address

SELF DECLARATION BY PARENTS/GUARDIANS

I, Mr./Mrs./Ms. (Titles, Full name of Parents/Guardians in CAPITAL letters)
Father / Mother / Guardian of Mr. / Ms. , (Full name of student in CAPITAL letters, Roll number) who has been admitted to Indian Institute of Technology Madras have:

I have read carefully and understood the Supreme Court Judgement on Ragging.
I have gone though of the Essential Extracts of relevant Regulations on curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the relevant Regulations)
Carefully read and fully understood the provisions contained there-in

I have, in particular, understood Clause 3 of the relevant Regulations and am aware as to what constitutes ragging and the implications thereof. I have also, in particular, understood Clause 7 and Clause 9.1 of the relevant Regulations and am fully aware of the penal and administrative actions that are liable to be taken against my ward ( , ) in case he/she is found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging. I hereby solemnly state and undertake that:

My ward , will not indulge in any behavior or act that may be considered as ragging under Clause 3 of the relevant Regulations.
My ward , will not participate in or abet or propagate through any act of commission or omission that may be considered as ragging under Clause 3 of the relevant Regulations

I hereby affirm that, if found guilty of ragging, my ward , is liable for punishment according to Clause 9.1 of the relevant Regulations, without prejudice to any other criminal action that may be taken against my ward , under any penal law or any law for the time being in force. I hereby declare that my ward has not been expelled or debarred from admission in any Institution in the country on account of being found guilty of, abetting or being part of a conspiracy to promote ragging, and further affirm that, in case this declaration is found to be untrue, my wards admission is liable to be cancelled.

Please Tick all the above Boxes

Name of the Parent:*

Please Fill the Name

Telephone/Mobile Number :*

Please Fill the Number

Signature :

SELF DECLARATION BY THE STUDENT

I, (Full name of student in CAPITAL letters)
S/o D/o Shri./ Smt. having been admitted to Indian Institute of Technology Madras, have:

Read carefully and understood the Supreme Court Judgement on Ragging.
Gone though the Essential Extracts of relevant Regulations on curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the relevant Regulations).
Carefully read and fully understood the provisions contained there-in

I have, in particular, understood Clause 3 of the relevant Regulations and am aware as to what constitutes ragging and the implications thereof. I have also, in particular, understood Clause 7 and Clause 9.1 of the relevant Regulations and am fully aware of the penal and administrative actions that are liable to be taken in case I am found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging. I hereby solemnly state and undertake that:

I will not indulge in any behaviour or act that may be considered as ragging under Clause 3 of the relevant Regulations.
I will not participate in or abet or propagate through any act of commission or omission that may be considered as ragging under Clause 3 of the relevant Regulations.

I hereby affirm that, if found guilty of ragging, I am liable for punishment according to Clause 9.1 of the relevant Regulations, without prejudice to any other criminal action that may be taken against the under any penal law or any law for the time being in force. I hereby declare that I have not been expelled or debarred from admission in any Institution in the country on account of being found guilty of abetting or being part of a conspiracy to promote ragging and further affirm that, in case this declaration is found to be untrue, I am aware that my admission is liable to be cancelled.

Please Tick all the above Boxes

Name of the student:*

Please Fill the Student Name

Telephone/Mobile Number :*

Please Fill the Student Number

Signature :

VEHICLE DECLARATION

I, , S/o hereby declare that I will not bring/use any powered vehicle inside IIT Madras campus and I will abide by the rules and regulations of IIT Madras.

If I fail to abide, appropriate action(s) can be taken against me.

Date :*

Signature of Candidate :

Signature of Parent: