National Institute of Fashion Technology, Kannur

(Ministry of Textiles, Govt, of India) A College of Design,

Management and Technology

Paste Passport
Student Profile Size
Photograph of
the student
Permanent Roll No.:………………………………………… Batch: …………………………………

Course: U.G. / P.G.

Discipline:
……………………………………………………

Name (As per 10th mark sheet) ……………………………………………………………………

Date of Birth & Age : ………………………………………………………………………………

Sex : Male Female

Category: Gen SC ST PHP OBC NRI NRI-sponsored

Blood Group : .....................................................

ID Mark : .....................................................

Mobile No. (if any) : .....................................................

E-mail address : .....................................................

Home Town & State : .....................................................

For NRI only (Country) :....................................................................

Permanent Address : .....................................................

(with Phone No.) .....................................................

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Communication Address :...............................................……….

(with Phone No.) .....................................................………..

NIFT Campus, Dharmasala, Mangattuparamba, Kannur, Kerala. Pin -670 007.

Tel.: (0497) 2784780, 2784783 Fax: (0497) 2784785 Head Office: New Delhi
 National Institute of Fashion Technology, Kannur
(Ministry of Textiles, Govt, of India) A College of Design,
Management and Technology

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Educational Qualification :…………………………………………………………..……

(Details of School / College) …………………………………………………………….……

Prizes / Awards received :…………………………………………………………….……

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Father's Name (in caps) : …………………………………………………………..

(As per 10th mark sheet / Govt Authorised ID Proof)

Father's Profession / : …………………………………………………………..

Office Address with Phone Nos. / : ………………………………………………………….

Mobile No/ E-mail
……………………………………………………………….

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Income (in Rs.) ……………………………………………………………….

Mother's Name (in caps) : .……………………………………………………………….

(As per 10th mark sheet / Govt Authorised ID Proof)

NIFT Campus, Dharmasala, Mangattuparamba, Kannur, Kerala. Pin -670 007.

Tel.: (0497) 2784780, 2784783 Fax: (0497) 2784785 Head Office: New Delhi
Academic Department
 National Institute of Fashion Technology, Kannur
(Ministry of Textiles, Govt, of India) A College of Design,
Management and Technology
Mother's Profession / : ………………………………………………………..

Office Address with Phone Nos. / : …………………………………………………………………

Mobile No./ E-mail
.……………………………………………………………….

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Income (in Rs.) ………………………………………………………………..

Local Guardian's Name ………………………………………………………………..

Address with Telephone No. ……………………………………………………………….

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Interests and Activities ……………………………………………………………….

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Mother Tongue ……………………………………………………………….

Languages Known ……………………………………………………………….

Any other ……………………………………………………………….

Date: Signature of the student

Undertaking to be given by all students at the beginning of each
Academic Year

I, ......................................................................................... son/daughter of

NIFT Campus, Dharmasala, Mangattuparamba, Kannur, Kerala. Pin -670 007.

Tel.: (0497) 2784780, 2784783 Fax: (0497) 2784785 Head Office: New Delhi
 National Institute of Fashion Technology, Kannur
(Ministry of Textiles, Govt, of India) A College of Design,
Management and Technology

.......................................................................... admitted to ……………………

………………………………………………….course of NIFT, Kannur centre hereby give undertaking

in respect of the following :

1. I will not smoke in the NIFT Campus, hostel, bus etc.

2. I will not consume liquor or drugs on any kind during the tenure in NIFT, in
the campus, hostel, bus or any other NIFT related activity or place.

3. I will not indulge in ragging directly or indirectly and will not resort to any
undesirable activity that may tarnish the image of NIFT.

4. In case of any harassment to me or others, I will bring the facts to the

notice of the centre SDAC / Registrar / Warden or any other immediate
available Officer of NIFT immediately. If any of these persons are not
available, the facts will be brought to the notice to the Centre Director
without delay.

I will abide by the above undertaking and all instructions given to me orally as well as
in writing from time to time. If I am found breaking the rules / instructions in any way
at any time, I am liable to be debarred from continuing with my programme or be
subject to any other action deemed fit by the NIFT authorities.

Place : ....................... Signature of the student ………………………….

Date : ....................... Name : ....................................

Address: .....................................

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Pin code: ……………………………………………….

Ph. : ……………………………………………….

Academic Department

NIFT Campus, Dharmasala, Mangattuparamba, Kannur, Kerala. Pin -670 007.

Tel.: (0497) 2784780, 2784783 Fax: (0497) 2784785 Head Office: New Delhi
Academic Department
 National Institute of Fashion Technology, Kannur
(Ministry of Textiles, Govt, of India) A College of
Design, Management and Technology

Group Insurance Policies for Students

Name of the Student : ……………………………………………………………………..

Batch: 20…… to 20…… Semester : ……………………………..

U.G TD KD FC FD BFT

P.G M. F. M M. Des.

Date of Birth & Age : ………………………………………………………………………..

Sex : Male / Female

Permanent Address : ………………………………………………………………………..
(with Phone No.)
: ………………………………………………………………………..

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Mailing Address : ………………………………………………………………………..

(with Phone No.)
………………………………………………………………………..

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Date of Admission : ………………………………………………………………………..

Contact Phone Number : ………………………………………………………………………..

E-mail Address : ………………………………………………………………………..

Qualification : ………………………………………………………………………..

Blood Group : ………………………………………………………………………..

ID Mark : ………………………………………………………………………..

Father’s/Husband Name: ………………………………………………………………………..

Mother’s Name : …………………………………………………………………………

Nominee Name/Relationship : ……………………………………………………………….

Date: Signature of the student

IHTT Campus, Thottada, Kizhunna P.O., Kannur, Kerala. Pin - 670 007.
Tel.: (0497) 2837080, 2837083 Fax: (0497) 2837084 Head Office:
New Delhi