Form No.

:No NATIONAL INSTITUTE OF TECHNICAL TEACHERS TRAINING & RESEARCH SHAMLA HILLS, BHOPAL 462 002 (M.P.) INDIA
Size 3.5 cm x 2.5 cm

Photograph (Self Attested)

APPLICATION FORM FOR ADMISSION IN M.E./M.Tech.

Application Form Fee ` 750/- for General/OBC candidates & ` 450/- for SC/ST candidates

FOR OFFICE USE ONLY

1. GATE : Score:... Year: Discipline: .. Rank :.. Application Reg.No. ______________ Sch. No. ________________________ Branch: 2. Aggregate % at Degree level/ Equivalent 3. Category (SC/ST/OBC/ General/Others) 4. Status of Candidature 5. Payment Details : (i) GATE Demand Draft. (ii) Sponsored (iii) Non GATE - Non Sponsored Drawn on ... Amount ` Date ....
Date of Admission.. ..

TO BE FILLED BY THE CANDIDATE

1. Personal Details & Correspondence Address:
(i) (ii) (iii) (iv) Name (in Capital) Fathers Name Mothers Name Address for Correspondence
Pin - . E-mail ID: Telephone: . Mob. No

(v)

Date of Birth

// DD / MM /YYYY

Gender: Male/Female Place of Birth________________ State _____________

(vi) (vii)

Category

SC/ST/OBC/General/Others Blood Group .. Nationality .. Religion

2. Details of Under Graduation & Qualifying Examination Level

(i) (ii) Branch at UG Level Aggregate Percent of Marks in the qualifying UG Exam Details of GATE Examination Exam : Total Marks:. Obtained Marks:.. Percentage : Year of Passing . Discipline of GATE Percentile ... GATE Score

(iii)

a) b) c) d)

3.
S.No. (i) (ii) (iii) (iv) (v)

Details of Programme Applied For :

PG Programmes Offered M.Tech. in Computer Technology & Application M.Tech. in Construction Technology & Management M.E. in Power Systems M.E. in Advanced Production System M.E. in Structural Engineering Write the Name of programme applied for :

4.
S.No.

Educational Qualifications
Exam / Degree Subjects / Branch Board / Institute and University Year of Passing Division Total marks obtained % marks / CGPA

(i) (ii) (iii) (iv)

10

th

Higher Secondary/10+2 UG Level (B.E./B.Tech/Equi.) Any other examination

5.

Experience in Chronological Order: (Use separate sheet, if required)

Post Held Pay Scale/ Salary Experience From Nature of work To

Name & Address of Employer

6.

Details of Application Form Fees:

` Dated

Bankers Chq. / Demand Draft No. Issuing Bank with branch

7.

Hostel Accommodation Needed:

YES

NO

Date : . Place : .

Signature of the Candidate

Name:

List of enclosures (self attested photocopies):

Self attested copies of following documents as applicablea) b) c) d) e) f) g) h) i) 10 Marksheet / Certificates as proof of Date of Birth Higher Secondary/10+2 Marksheet/Certificate Marksheet/Grade Cards of Qualifying Examination (B.E. / B.Tech./ MCA etc.) GATE Score and GATE Admit Card Sponsorship Certificate with No Objection Certificate from present employer(For sponsored candidate) Caste Certificate (For SC/ST/Other Backward Classes ) in Govt. of India Format Income Certificate from competent authority (for other Backward Classes) Two passport size photographs Bankers Chq. / Demand Draft
th

Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No

Note: At the time of admission, all certificates and documents in original including migration & character certificate.
Declaration by the Candidate I hereby declare that the information given above is correct. In case any of the information given by me is found incorrect my application is liable to be rejected / admission is liable to be cancelled. Further, I assure that if admission is given to me, I shall abide by the rules and regulations of the institute, statutes, ordinances of the affiliating university and changes incorporated therein from time to time and shall maintain the discipline of the Institute. Signature of the Candidate Place : Date : . Counter Signature of Father / Guardian

Employers Certificate for Sponsored Candidates This is to certify that Mr. / Ms. (Fathers / Husband name) .. is working in . (Name & address of Employer/ Organization/Institute) as. on Regular / Full time basis and he / she is sponsored and permitted to join the Full time M.E./M.Tech Programme of NITTTR, Bhopal. If selected as a sponsored candidate the organization has no objection and he/she will be allowed to continue full time M.E./M.Tech Programme till the completion of the programme at NITTTR, Bhopal.
Date: Place: Signature of Competent Authority with official seal

Verification Sheet (for Office use only)

1. Name: ...........2. Category : Gen./SC/ST/OBC/Others: 3. Branch at B.E./B.Tech./MCA/Equivalent 4. UG Level year of passing Percentage/CGPA . 5. GATE : Year of passing . Score Percentile

Verified and admitted provisionally to the First Semester Full Time course in .. Formalities to be completed (if any) By date ..

(Signature of admission committee members)

(Signature of candidate at the time of admission) Date :