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International Collaborative Program APPLICATION 2018 19

This document is an application form for admission to the 6-year International Collaborative Program (ICP) between JNTUK University in India and Blekinge Institute of Technology (BTH) in Sweden. The form requests student information, choice of B.Tech program, details of educational qualifications and entrance exam scores, years studied in English medium, and list of documents to enclose. It includes a self-declaration of truth and completeness and space for student and office signatures.

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Aravind Shankar
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80 views2 pages

International Collaborative Program APPLICATION 2018 19

This document is an application form for admission to the 6-year International Collaborative Program (ICP) between JNTUK University in India and Blekinge Institute of Technology (BTH) in Sweden. The form requests student information, choice of B.Tech program, details of educational qualifications and entrance exam scores, years studied in English medium, and list of documents to enclose. It includes a self-declaration of truth and completeness and space for student and office signatures.

Uploaded by

Aravind Shankar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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JNTUK-DA-International Collaborative Programmes – Admissions- 2018-19

JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY KAKINADA Affix Your


KAKINADA-533003, ANDHRA PRADESH, INDIA, www.jntuk.edu.in Latest
Colour
Photo &
Application form for Admission into JNTUK-BTH, 6 years International Collaborative Program (ICP). sign
(B.Tech & B.S + M.S)

General instructions: Applicants should fill in this form completely and send it along with DD in favour
of Registrar, JNT University Kakinada., payable at Kakinada with all enclosures to The Director of Admissions, JNTUK,
KAKINADA – 533 003,Andhra Pradesh, India on or before 09.06.2018 by 5pm.

1) STUDENT INFORMATION:

Name (as per 10th Class/Passport)


Father / Mother Name
Date of birth (dd/mm/yyyy) Gender: Male / Female
Nationality
Address for Communication
(Give Pin/ZIP code also)

Mobile : Landline: Email:


Passport Details: Passport Number: Date/Place of Issue:
Local /Non – Local Details

2) 6-Years ICP (B.Tech & B.S + M.S ) Program with exit option :

COURSE APPLIED FOR:(Tick √ appropriate Course and write order of preference in the preference Colum provided (1,2&3)

S.No Branch PUT √ MARK Preference


1 B.Tech - Mechanical Engineering
2 B.Tech - Electronics and Communications Engineering
3 B.Tech - Computer Science and Engineering

 6 Years International Collaborative Program (3+1+2) with exit option at the end of 4 th Year (3 Years of study at
JNTUK and 1 Year of study at BTH - Sweden +2 years of study for Masters at BTH – Sweden(optional)
 At the end of 4th Year 1st semester if the student desires to continue Masters Program, he/she shall apply separately to
the BTH - Sweden.
 For Complete details i.e Branches and Specializations offered, please look into the “Information Booklet” available in
the website.

3) DEMAND DRAFT DETAILS:Rs.1500/- in favour of “The Registrar, JNT University Kakinada, payable at Kakinada”

Name of the Bank DD Number Date of Issue Amount


Rs.1500/-
JNTUK-DA-International Collaborative Programmes – Admissions- 2018-19

4) EDUCATIONAL QUALIFICATIONS:
Qualification Name of Name of the Month/ Year Medium of Division, Marks
Examination University/ Board of Passing Instruction Secured & %
Marks
SSC (10th// Equivalent )
Intermediate/Equivalen
t
(10+2)

5) ENTRANCE EXAMINATIONS DETAILS:


Name of The Entrance Examination Marks Obtained Rank Remarks
JEE MAINS-2018
AP EAMCET-2018
TS EAMCET-2018

6) NO. OF YEARS STUDIED IN ENGLISH MEDIUM : 2 Years / 5 Years/ 10 Years or more

NO. OF YEARS STUDIED WITH ENGLISH AS A SUBJECT : 2 Years / 5 Years / 10 Years or more

7) LIST OF DOCUMENTS TO BE ENCLOSED

DD for Rs.1500/- in favour of Registrar, JNTUK,


Kakinada, payable at Kakinada.

SSC/Secondary Education (10th class) Certificate

Qualifying Examination/Intermediate or (10 +2) or equivalent Certificate

Transfer Certificate and Study Certificate.

Details of Qualifying Entrance Examinations (JEE MAINS/AP EAMCET/ TS EAMCET) Rank Card etc....

8) SELF DECLARATION: I declare that all statements made in this form are true and complete. I understand that untrue
statements may cause Expulsion from the programme.

PLACE: SIGNATURE:

DATE: NAME:

OFFICE USE
Registration No: Application Fee Amount : Rs. 1500/-
DD No :
BANK :

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