Scribd
Upload
160 views3 pages

Registration Form ME-MTech

This document is an application form for admission to various postgraduate engineering programs: M.E. (Environmental Engineering), M.Tech. (Computer Science and Engineering), M.Tech. (Power Electronics), and M.Tech. (Software Engineering). The form requests information such as the applicant's name, date of birth, gender, category, address, contact details, qualifying examination details, GATE exam details if applicable, employment details, and application fee payment details. The applicant must declare that the information provided is true and sign the form.

Uploaded by

abhishek_tiwari_it1483
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
160 views3 pages

Registration Form ME-MTech

This document is an application form for admission to various postgraduate engineering programs: M.E. (Environmental Engineering), M.Tech. (Computer Science and Engineering), M.Tech. (Power Electronics), and M.Tech. (Software Engineering). The form requests information such as the applicant's name, date of birth, gender, category, address, contact details, qualifying examination details, GATE exam details if applicable, employment details, and application fee payment details. The applicant must declare that the information provided is true and sign the form.

Uploaded by

abhishek_tiwari_it1483
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

Session 2010-11

Application Form for Admission into


M.E. (Environmental Engg.)

M.Tech. (Computer Science & Engineering)

M.Tech. (Power Electronics)*

M.Tech. (Software Engg.)*

M.Tech. (Thermal Engg.)*


* AICTE approval awaited

Note: 1. Please tick mark the course of your choice

2. Please use separate application forms in case you want to apply for
more than one course

Affix
passport
size colour
photograph

1. Name of the Course Applied For : ……………………………………………………

2. Name of the Applicant : ……………………………………………………

3. Date of Birth : ……………………………………………………

4. Gender (Male / Female) : ……………………………………………………

5. Category : General / SC / ST / OBC / Other

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

Page 1 of 3
7. Address :……………………………………………………………

…………………………………………………………….

8. Mobile No. : …………………………………………………………..

9. Qualifying Examination Details

(a) Name of Examination Passed : Graduation / Post Graduation


(Please tick the appropriate)
(b) Branch / Subject : …………………………………………

(c) Year of Passing : …………………………………………

(d) % of marks obtained : …………………………………………

(e) University : …………………………………………

10. “GATE” Exam Details

(a) Year of Qualifying : …………………………………………

(b) Score : …………………….. (c) Rank : ……………………………..

11. Quota for Admission : General / Sponsored*


(Please tick the appropriate)
12. Employment Details

(1) Whether employed : Yes / No

(2) If employed, name of the organization / institution where employed :

……………………………………………………………………………………….

(3) Since when employed : ………………………………………………….

(4) Designation : ………………………………………………….

13. Application Fee Details:

Demand Draft No. Date Bank Amount

Rs. 500/-

*For those in employment

Page 2 of 3
DECLARATION

I hereby affirm that the information given above is true to the best of my
knowledge and belief. I shall be solely responsible for the consequences including
cancelation of my admission to the course, in the event of any of the information being
found false.

Signature :
Name :
Date :
Place :

Enclosures to be attached with the application

1. Attested copy of class 10th Mark sheet


2. Attested copy of class 12th Mark sheet
3. Attested copy of Graduation Mark sheet
4. Attested copy of Post Graduation Mark sheet ( if applicable )
5. Attested copy of experience certificate from employer
6. Attested copy of NOC form employer
7. Attested copy of sponsorship certificate
8. Pay Order/Demand Draft for Rs. 500/- towards Application Fee (if not paid
already) OR proof of payment of Application Fee

Page 3 of 3

You might also like