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Indian Statistical Institute: Application For Admission 2013-2014

This document is an application form for admission to the Indian Statistical Institute for the 2013-2014 academic year. It requests basic personal information such as name, address, date of birth, gender, caste, nationality, physical disability status if any, preferred course and city of study, academic qualifications and marks, details of any relevant exams like GATE, bank draft information for application fees, employment details if applicable, and a declaration agreeing to the institute's rules if admitted. It instructs applicants to read guidelines carefully before filling the form and to submit the completed form by March 6, 2013.

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65 views2 pages

Indian Statistical Institute: Application For Admission 2013-2014

This document is an application form for admission to the Indian Statistical Institute for the 2013-2014 academic year. It requests basic personal information such as name, address, date of birth, gender, caste, nationality, physical disability status if any, preferred course and city of study, academic qualifications and marks, details of any relevant exams like GATE, bank draft information for application fees, employment details if applicable, and a declaration agreeing to the institute's rules if admitted. It instructs applicants to read guidelines carefully before filling the form and to submit the completed form by March 6, 2013.

Uploaded by

space1com
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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INDIAN STATISTICAL INSTITUTE

APPLICATION FOR ADMISSION 2013-2014


(Read instructions carefully before filling in the form)
For Office Use Only

For Office Use Only

Form No.:

Paste Stamp Size Photograph

Put your signature in the above box Do not Staple

1. Full Name (in CAPITAL letters):

2. Address for Correspondence (in CAPITAL letters):[Please leave a box between two words]

PIN : STATE : TEL. NO. (including STD code)/MOBILE NO. E-mail (if any): COUNTRY :

3. Date of Birth : 4. Sex: 6. Caste:

day

month 5. Nationality :

year

(Male/Female/ Other)

(General/SC/ST/OBC) (Y/N) 1st preference 1st preference 2nd preference (Y/N)


(Y/N).

(See Section 4, page 8 of the Prospectus)

7. Physical Disability (if any) :


(See Section 4, page 8 of the Prospectus)

If yes, percentage of disability : 2nd preference


(Valid only for B Stat & B Math)

8. Course Code:
(For Course code see page 42 of the Prospectus.)

9. City Code:

3rd preference

(See page 43 of the Prospectus)

10. (a) Are you an INMO awardee? (b) Do you have a valid GATE score? Subject : Marks out of 100 (c) Are you appearing# for GATE in 2013 ?

If yes, year of award : If yes*, then All-India rank : Year : GATE Score:

(for B Stat and B Math only. See pages 9 and 10 of the Prospectus.)

* Must enclose a copy of his/her GATE score card containing all the above information.

(Y/N).

# Must send a scanned copy of his/her GATE score card containing all the above information by e-mail to [email protected] mentioning ISI Regn No. by 13 April 2013.

11. Bank Draft No. : Bank Name :


Page 1 of 2

Amount in Draft Date :

(If you have downloaded this form, also attach the Bank draft with the filled-in Application Form.)

12 (a). Academic Record: Give details of all academic examinations in which you have passed/appeared indicating % of marks/ GPA and class in appropriate columns.
Examination (Put in the appropriate box)
Secondary/ (or equivalent) Higher Secondary (or equivalent) Humanities (BA) Science (B Sc) Engineering (BE/B Tech) BCA Humanities (MA) Science (M Sc) Engineering (ME/M Tech) MCA Others (specify) University/ Board Year of passing Subjects (indicate Hons/Major) Total Marks Obtained (%)/ GPA Math Marks (%)/ GPA Stat. Marks (%)/ GPA Class / Division

(a) Other Academic Achievements, if any :

(b) If you are yet to complete the qualifying examination, give the probable month of (i) completion of the examination including practicals : (ii) announement of results : 13. Have you ever been admitted to a course at the Indian Statistical Institute? If yes, then Course(s) 14. Father's Name : 15. Mother's Name : 16. Guardian, Name : Guardian's name Name Address : Tel: 17. If you are employed (a) Employement Status (b) Designation (d) Employer's Address (e) Experience (if any) : : : Session : Occupation : Occupation : Relationship: ( Y/N)

Declaration to be signed by the applicant: The above particulars submitted by me are correct. If admitted, I shall not (a) leave in the middle of the course, (b) violate the discipline code of the Institute, or (c) indulge in any activity hampering the progress of my studies and spoiling the environment of the Institute.

Date : . . . . . . . . . . . . . . . . Signature of the applicant with date


NB: Filled-in Application Form should reach Dean of Studies, Admission 2013, Indian Statistical Institute, 203 B T Road, Kolkata 700 108 in a sealed A4 cloth envelope by 06 March, 2013.
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