REGISTRATION FORM – M.TECH IN MECHANICAL ENGG. Application No. ………………
MORADABAD INSTITUTE OF TECHNOLOGY APPLICATION FOR REGISTRATION FOR ADMISSION TO M.TECH. IN MECHANICAL ENGG. FOR THE SESSION 2015-16 1.
Name of the Applicant
………………………………………………
2.
Father’s Name
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3.
Mother’s Name
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4.
Permanent Resident of & Its Address
……………………………………………… ……………………………………………… ………………………………………………
5.
Present Address for communication
……………………………………………… ……………………………………………… ………………………………………………
6.
Telephone Nos.
………………………………………………
7.
Mobile Nos.
………………………………………………
8.
Email ID
………………………………………………
9.
Date of Birth
………………………………………………
10.
Gender
………………………………………………
11.
Category (Gen/OBC/SC/ST) ……………………………………………... Self Attested Copy of Caste Certificate to be attached for OBC/SC/ST) Caste Certificate for OBC to be of after 1 April 2015
12.
Appeared in GATE
13.
Percentile in GATE (Self Attested Copy of GATE marksheet)
14.
Academic Details :-
Class
10th 10+2 B. Tech
Roll No.
Year ……………….
Subject
Board/ University
Max. Marks
.………………
Marks Obtained
Year
Percentage
15.
Parent’s Occupation
……………………………………………...
16.
Parent’s Annual Income
……………………………………………...
17.
Whether in the list of 25 % top graduates of UPTU students If yes, proof to be submitted Teaching/Research/Industry Experience (Proof to be submitted)
18.
19.
Yes / No ……………….
Registration Amount Rs. 10,000/- deposited vide (Bank details) ………………………… …………. DD No. ……………….... dated …………………. and Processing Charges Rs. 1,000/- deposited vide (Bank details) ………………………… ………………………………. DD No. ……………….... dated …………………. both in favour of Moradabad Institute of Technology, Moradabad.
D E C L A R A T I O N I hereby declare that I am applying for admission with the clear understanding that :1.
Registration is not a guarantee for admission.
2.
Admission will be offered by the institute on the basis of merit in the B.Tech., GATE score, Experience/ as per the directives of UPTU in this regard.
3.
The details of Rs. 11,000/- being deposited are as under :(a)
Rs. 10,000/- is the Registration amount which will be adjusted against the fees incase admission is taken in this Institute in the year 2015-16. Rs.1,000/- will be refunded if admission to any one of the branches applied for is not offered. It may take about two weeks after the admission process is over.
(b)
Rs. 1,000/- is the Processing Amount and is non-refundable and non adjustable.
4.
The registration amount will be forfeited, if admission offered for is not accepted by the candidate.
5.
Request for cancellation of registration and subsequent refund of Rs. 10,000/- may not be considered in the intervening period between registration and admission.
Signature of father/Guardian
Signature of Candidate
as a token of having agreed with the
Name …………………………..
declaration made by his son/ward
Date …………………………..
Name ……………………………… Date ……………………………… Enclosures :
1. 2.
3. 4.
Photocopy of Marksheet of B. Tech. Examination. Demand Drafts bearing No. …………………. dated …………... for Rs. 10,000/- (Ten Thousand Only) and DD No. ….…………….. dated ……………….. for Rs. 1,000/- (Rupees one thousand only) both in favour of Moradabad Institute of Technology, payable at Moradabad. Caste Certificate Proof of B. Tech./GATE/UPTU merit/experience.
