Page 1 of 4

Application No: 20173

Government of Kerala
DEPARTMENT OF TECHNICAL EDUCATION

APPLICATION FOR ADMISSION TO

M.TECH / M.PLANNING DEGREE COURSE 2015 - 16
1. Name in CAPITAL Letters, beginning from the left; initials at the end of the name.(Please insert one letter in a box)
A R U N R A J
K
2. Postal Address

N G O QUERTERS(B 18)
BALLA(P O)
KANGHANGAD

Affix

KASARGOD
Pin Code

recent

671531

passport size
photo

3 (a) Contact Telephone Number

STD Code

4. Date of birth in Christian Era

Land Phone

0 4 6 7 2

Day

Mobile No. 9 5 2 6 4 7 3 7 7 5
5

Month
1

Year

E mail address,if any.

arunraj113@gmail.com

Sex

Is Keralite

Religion

Caste

Reservation Category

Male

Yes

HINDU

PULAYAN

SC

Non-Creamy
Layer

--

Details of GATE Examination passed

Year

Reg.No.

Score

Mark

2014

CE107101022

267.00

19.04

Details of Qualifying Examination

Degree

B.Tech

Branch

Civil Engineering

University

KANNUR UNIVERSITY

Name of the College

GOVERNMENT ENGINEERING COLLEGE KANNUR

Is the College approved by AICTE

Yes

Year of Passing

2014
Semwise Mark/SGPA Details

Semesters

Marks/SGPA Scored

Total Marks/SGPA

Sem 1 & 2

950

1450

Sem 3

711

1200

Sem 4

765

1200

Sem 5

811

1200

Sem 6

722

1200

Total Marks in all Semesters up to and including sem 6

3959

Maximum Marks in all Semesters up to and including sem 6

6250

Fee Amount

100

Whether Physically Challenged

No

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10 Sponsored Candidate

No

11 Choice of specialisation in the order of preference

Choice

College

Specialisation

Category

TVE

Traffic and Transportation

GATE

TVE

Geotechnical Engineering

GATE

TVE

Environmental Engineering

GATE

TVE

Structural Engineering

GATE

Engineering

TVE

Hydraulics Engineering

GATE

TCR

Environmental Engineering

GATE

RIT

Transportation Engineering

GATE

TCR

Water Resource and Hydro

GATE

Informatics
9

KNR

Computer Aided Structural

GATE

Engineering
10

TVE

Geo Informatics

GATE

11

NSS

Structural Engineering

GATE

12

TKM

Structural Engineering and

GATE

Construction Management
13

MAC

Structural Engineering and

GATE

Construction Management
14

TVE

M.Plan - Planning (Housing)

GATE

15

TCR

M.Plan - Town Planning

GATE

DECLARATION
(To be filled by the candidate)

I, ............................................................. hereby solemnly and sincerely affirm that the statements made and information
furnished in this application and also in the enclosures thereof submitted by me are true to the best of my knowledge and belief.I
hereby agree to abide by the rules and regulations of the college,if admitted.
Place:
Date:

Signature of the Candidate

Note: 1.Late applications, those which do not contain the necessary documents specified in clause of the prospectus and in which any certificate is found defective, will
be rejected.
2.Those who have not secured qualification from the universities in Kerala state ,shall produce equivalency certificate at the time of admission/counseling.

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List of Enclosures:
Self attested true copy of Engineering Degree certificate and Mark lists.
Self attested true copy of GATE Score card (for Candidates with valid GATE Score)
Self attested true copy of non creamy layer certificate for candidates who claim eligibility under SEBC(OBC)/OEC
Self attested true copy of Community certificate issued by the Tahsildar for candidates who claim eligibility for reservation under SC/ST quota.
Self attested true copy of professional experience certificate from the Head of the organizations where the candidate is working in case of
those who passed AMIE/AMIETE.
Self attested true copy of Nativity Certificate.
Counterfoil of Chalan after remittance of application fee in any branch of SBT.
Additional Certifiates:
Self attested true copy of Sponsorship Certiciate for candidates applying under the sponsered category.
Self attested true copy of Physical Disability Certificate for candidates who claim eligibility under the Physical Disability quota.

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Instructions to Bank:Please note to enter the Application No and Student name in the mandatory fields while posting the amount in the Current Account.
STATE BANK OF TRAVANCORE

Fee Payment Voucher

Branch:
Challan No:

Bank Copy

To be Filled by Student
Date:............................
Please credit the amount towards Application Fee to the account of DIRECTORATE OF TECHNICAL EDUCATION Account No. 67179772330
with SBT, Fort Branch,Trivandrum - code - 481.
Application No

20173

Name of Student:

ARUNRAJ K

Amount:

Name of Degree:

Commission:

100

10

Name and Address of Student:

N G O QUERTERS(B 18)
BALLA(P O)
KANGHANGAD
KASARGOD 671531
Mobile Number: 9526473775

MTECH

Total:

110

Bank Seal

Amount in words: One Hundred and Ten Only

Signature:................................. Cashier:

Passing Officer:

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Branch:
Challan No:

To be Filled by Student

Student Copy

Date:............................
Please credit the amount towards Application Fee to the account of DIRECTORATE OF TECHNICAL EDUCATION Account No. 67179772330
with SBT, Fort Branch,Trivandrum - code - 481.
Application No

20173

Name of Student:

Name of Degree:

ARUNRAJ K

Amount:

100
Name and Address of Student:
N G O QUERTERS(B 18)
BALLA(P O)
KANGHANGAD
KASARGOD 671531

Commission:

10

MTECH
Total:

110

Bank Seal

Mobile Number: 9526473775

Signature:................................. Cashier:

Passing Officer:

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Orginal Copy

Branch:
Challan No:

To be Filled by Student

To
be submitted along with the Application
_____________________________________

Date:............................

Please credit the amount towards Application Fee to the account of DIRECTORATE OF TECHNICAL EDUCATION Account No. 67179772330
with SBT, Fort Branch,Trivandrum - code - 481.
Application No

20173

Name of Degree:

Name of Student:

ARUNRAJ K

Amount:

Commission:

100
Name and Address of Student:

10

N G O QUERTERS(B 18)
BALLA(P O)
KANGHANGAD
KASARGOD 671531

MTECH
Total:

110

Bank Seal

Mobile Number: 9526473775

Signature:................................. Cashier:

Passing Officer: