Application Form for Admission to

First Year B. Tech. Programme - 2011

Form No: WEB DOWNLOADED
Form Fee: Rs.1000/- Last Date of Submission of the Form: June 07, 2011

(For Office Use Only)

Received By : ______________________________ Registration No. : ___________________ __ ___
( )
Checked By :_______________________________ Verified By : _______________________ __
( ) ( )

AIEEE – 2011: All India Rank: ____________________ 25 % Seats (All-India) Merit No.: ____________________

75 % Seats (Gujarat State) Merit Marks: _________________ 75 % Seats (Gujarat State) Merit No.: ________________

Entered by: __________________________ Checked By: __________________________

( ) ( )

Admitted In : _____________________ Signature of Officer In-Charge: ______________

(To Be Filled in by the Candidate)
Note: -
1. Use Capital letters only. Affix a recent
2. Tick ( √ ) in relevant box. passport size
3. Read the instructions carefully before filling up this form. photograph and sign
4. Attach duly self attested copy of all the documents. across it
5. The application made under the category of 75 % (Gujarat State) will also be considered
under 25% (All – India) category.

1. Name (As per School Leaving Certificate) :

2. Sex : MALE FEMALE Date of Birth: 1 9

D D M M Y Y Y Y

3. Address for correspondence:

City State PIN

Phone : (R) (O) ____________________________

(STD Code) (STD Code)

Mobile: (Applicant) 0
E- mail ID: ____________________________________
(Parent) 0

4. Last school attended – Location : Within Gujarat Outside Gujarat

5. AIEEE-2011 Roll number :

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6. (a) Name of the 12th Science Examination Board (For Schools Located Within Gujarat):
Board : GSHSEB : CBSE : ICSE: OTHER BOARD :
(b) Name of the Board (for Schools Located in India – Outside Gujarat): _______________________

__________________________________________________________________________________

(i) Enter 12th Science Subject Marks:

Subject ´ Mathematics Chemistry Physics Total English
Marks Obtained
Theory
Maximum Marks
Marks Obtained
Practical
Maximum Marks

Grand Total Marks Obtained

of Std. 12 Maximum Marks Obtainable

(ii) 10th Standard Examination Details:

% of marks obtained .
7. We hereby declare that
• The information given by us in the application is true.
• We are aware that providing incorrect information in the application form may result in cancellation of the
admission secured, any time during the entire period in the institute.
• We shall abide by all the rules and regulations prescribed by Nirma University and/or Institute of Technology,
Nirma University.
• We have read the rules / procedure and other details for admission in Institute of Technology, Nirma University
and shall abide by the terms and conditions mentioned therein.

__________________________ ____________________________
(Signature of Parent / Guardian) (Signature of Applicant)

List of self attested copies of documents attached:

(Applicant and Parent/Guardian to sign on the back side of all the mark sheets and Certificates).

Please √ in the box below wherever copies are attached:

a. S.S.C.E. Mark sheet c. School Leaving Certificate

b. H.S.C.E. Mark sheet(s) of all attempts d. Admit Card of AIEEE – 2011

Note:
1. Statement of Practical marks (issued by authority) is required to be attached, in case these marks are not
shown separately in the Std. 12 Marksheet.
2. AIEEE – 2011 scorecard need not be sent. It will be downloaded from AIEEE website by Admission Committee.
3. In case of application form downloaded from the university website, demand draft of Rs. 1000/- drawn in the
favour of “Institute of Technology, Nirma University” payable at Ahmedabad is to be sent along with the
application form.

Provide DD details: DD No.___________ Date of Issue: ____________ Issuing Bank: ______________________

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 Admission to First Year
B. Tech. Programme - 2011

Instructions & Information

Programme Total Intake 75% Seats 25% Seats

Chemical Engineering 60 45 15

Civil Engineering 60 45 15

Computer Engineering 120 90 30

Electrical Engineering 60 45 15

Electronics & Communication Engineering 120 90 30

Information Technology 60 45 15

Instrumentation & Control Engineering 60 45 15

Mechanical Engineering 60 45 15

Eligibility:

(i) Candidate should have appeared in AIEEE-2011.

(ii) Candidate must have passed 12th Science Examination with Physics, Chemistry and Mathematics with
the percentage of marks as to be decided by the Government of Gujarat under the rules of admission.

Mode of Admission:

1. 75% seats shall be filled-in by the candidates who have passed 12th Science Examination from the schools
located in Gujarat State on the basis of merit considering equal weightage of marks obtained in AIEEE 2011
and the marks obtained in the theory of Physics, Chemistry and Mathematics.
2. 25% seats shall be filled-in by the candidates who have passed 12th Science Examination with above
mentioned subjects from the schools located in India (including Gujarat State) on the basis of All India Rank
of AIEEE 2011.
3. In case, if % of final merit marks arrived are equal in case of 75% seats category, the criteria, in sequence,
for deciding the merit order will be followed as per the admission rules of Government of Gujarat.
4. Provisional merit list with detailed programme of counselling will be displayed at the office of the Institute
and on the website: http://www.nirmauni.ac.in.
5. Those who are called for counseling will be informed by either of the modes e.g. post / courier / telephone /
e-mail / SMS.

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Counseling Process:

• Applicant shall remain present in person with all original documents for verification on the notified date.
• If applicant is unable to remain present in person, due to unavoidable circumstances, parent with authority
letter from applicant will be permitted, provided the admission committee is satisfied for the genuinity about
the applicant’s inability to remain present.
• If applicant does not remain present on the scheduled date & time and remain present afterward, he / she
will be offered admission in the programme available at that time.
• If applicant has passed 12th Science examination from board other than Gujarat Higher Secondary
Education Board, he / she will be required to obtain the eligibility certificate from Nirma University for which
he/she will be required to pay Rs. 500/-.

Interpretation of Clauses:

In case of doubt in interpretation of any clause(s) or in a dispute on any issue, the decision of the Chairman
of the UG Admission Committee - 2011 shall be final.

Submission of Application Form:

• Either in person or by registered post or by courier to the following address.

• Application received after the last date (i.e. June 07, 2011) will not be considered for admission.
• Timings for submission of duly Completed Application Form (on all working days):
Monday to Friday: 11:00 a.m. to 3:00 p.m.
Saturday: 11:00 a.m. to 1:00 p.m.

Address for Correspondence:

To,
Admission Officer,
UG Admission Committee 2011
PG Building,
Institute of Technology, Nirma University,
Sarkhej - Gandhinagar Highway,
AHMEDABAD-382 481
Gujarat, India

Phone Number: (02717) 241911 - 15

Admission Office (Direct): (02717) 241271
Fax: (02717) 241917
E-mail: [email protected]
Website: www.nirmauni.ac.in

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