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Form received on:

Application Form No. .......................

COLLEGE OF TECHNOLOGY AND ENGINEERING
Mahrana Pratap University of Agriculture and Technology, Udaipur - 313 001 (INDIA)

Admission Form for

Admission in (i) M.Tech. (ii) Ph.D.
in Faculty of Engineering & Technology
Academic Session: 2015-2016
Last date of receiving application: 30th June, 2015

Please affix recent

passport size
photograph here

Application Fee Details (to be filled by the candidate)

Amount:
DD No.:
Date:
Bank & Branch:

Details of Program in which Admission is sought:

Program Applied For (Tick one):
Branch/Discipline:
_________________________
Specialization Preferences (Enter Codes)
1.

2.

3.

4.

5.

6.

M.Tech.

Ph.D.

A . PERSONAL DATA
1.
Name of the Candidate:
(as per the secondary
school certificate)

2.

Gender: (Male/Female)

3.

Fathers Name:

4.

Mothers Name

5.

Address for
Communication:
Pincode:
Email:

6.

Mobile No.:

Permanent Address:
(if different from the
address for
communication)

Pincode:
7.

State & District of Domicile:

8.

Date of Birth:

10.

Caste Category
(Gen./SC/ST/OBC/SBC):

11.

Valid GATE Score & Year:

12.

Qualifying Degree with

major specialization:

13.

Are you a Sponsored Candidate? (Yes/No)*:

14.

If Yes, the name of organization:

9.

Nationality:

13.

Percentage of
Marks/ OGPA:

______________________________________________
*Candidates applying as Sponsored candidates shall not be considered for non-sponsored seats. They should submit a
separate application with fee along, if they want to be considered for normal seats.

B. EDUCATIONAL QUALIFICATIONS
Examination Passed

Name of
Examination/
degree

Major
Subject(s)

Year of
Passing

Board/University

OGPA/
Percentage

Secondary
Higher Secondary (10+2)
Bachelors Degree
Masters Degree
C. EMPLOYMENT DETAILS
Designation
Name of Employer

Period
From

Experience in months
To

DECLARATION BY THE STUDENT

I declare that the above information is correct and that I have read all the rules and regulations of the College
and the University to which I will abide during the studentship.
I declare that I have not been convicted for any criminal offence. No criminal case or proceeding is presently
pending against me in any court of law. I have not resorted to any act of indiscipline during the previous years.
I solemnly declare that I have not been debarred from joining any educational institution or rusticated from the
Institution/University/Board last attended.
I solemnly declare that I have passed my qualifying examination as a regular student of a recognized
institution. In all matters, the rules & regulations related to the institution and its hostel, the order of the officer
concerned will be binding on me.
I hereby agree and promise that I shall not institute any law suit arising out of this application and subsequent
matters in any court of law other than the situated within city limits of Udaipur.
I solemnly declare that the statements made in this application are true to the best of my knowledge and belief.
I clearly understand that if any of the statement is subsequently found to be untrue. I will render myself liable
to immediate removal from the college and I may be prosecuted.
I enclose herewith a D.D. No.___________ for Rs. 1000/- drawn on the Bank ______________________
dated _______ as application fee.

Place:
Date:

Signature of Applicant

DECLARATION BY THE PARENTS/ GUARDIAN

I,.. S/o .. hereby undertake full responsibility for discipline and

good conduct of my child/ward. Its violation will render him liable to be removed from the college. I will not
claim refund of any fee and also clear all dues against him. Further the statements made in the application by
my ward are true to the best of my knowledge and belief.

Attested by Gazetted Officer

Signature of any Parent/ Guardian

Signature & Seal

Name & address

FORMATS OF DIFFERENT CERTIFICATES

CERTIFICATE OF GOOD CHARACTER
(To be compulsorily attached by all candidates)

Certified
that
Mr./Mrs./Ms..
Son/daughter of Shri ..has been a student of this institution beginning from
the session . till the end of the session During this period, nothing against his/her
character has come to my knowledge.

Place:
Date:

Signature and Seal of the Head of the Institution last

attended

CERTIFICATE OF PHYSICAL FITNESS

(To be compulsorily attached by all candidates)

Certified that I have examined Mr./Mrs./Ms. . Son/daughter of Shri.

and found that he/she is free from any disease (communicable or otherwise), constitutional
weakness or bodily infirmity which would debar him/her from admission to M.Tech./Ph.D. including residence
in the hostel. His/her age by appearance is years. The following observations have been recorded by
me personally.
Height: . cms

Chest Normal .. cms

Weight: kg

Chest Expanded cms

Marks of identification ..
Place:

Signature and seal of the Medical Officer

Date:

Medical Council Registration Number:

Note: The medical officer is requested to examine the candidate carefully and to satisfy himself that the candidate
will be able to put in hard work and that he/she has no ailment which would make his/her stay in the hostel a source
of danger to the others.

CASTE CERTIFICATE
(Certificate to be produced by candidates belonging to Scheduled Caste/Scheduled Tribe/ O.B.C.)

This is to certify that Mr./Mrs./Ms .. Son/Daughter ofof

Village. District/Division. State belongs

to

the

community, which is recognized as Scheduled Caste/Tribes/OBC o f A c t / Order No.

. Dated applicable in the state His/her family ordinarily resides in the
village/Town.

of

District/Division

State/

Union

Territory

of

...
Signature of Ist Class Magistrate with Seal

Date:

Note: In case of OBC/SBC seats, certificate of caste should not be older than six months from date of advertisement,
taking into account creamy layer clause.

SPONSORSHIP CERTIFICATE
(To be printed on the official letter head)

The undersigned is pleased to sponsor Mr./Ms. ............................................................ who is working in

this organization since .. as a permanent and regular employee and is presently holding the
rank/position of ........................................ for pursuing the program (name of course)
at College of Technology & Engineering, Udaipur as a full time regular student.
His/her conduct and character has been good.
The Institution/Organization would relieve him/her immediately for joining the above course on scheduled
date, if selected for admission.
Further, the candidate shall remain in employment of the Institution/Organization during the entire period
of study (2 years for M. Tech. and 3 years for Ph. D.) and the sponsorship for admission will not be
withdrawn midway till completion of the course.
Our Institution/ Organization is registered in a stock exchange/ had an annual turnover of over
Rs... Crores in the past two years (for candidates working in a Firm/Company/Industry).
Our Institution/Organization is a State/Centre Government Department/ Autonomous Body under the
Government/ Research Organization of the State/Centre Government (strike-off whichever is not
applicable).
The Institution/Organization is an educational institute recognized by ICAR/AICTE. (In case of an
educational institute)
The undersigned is the appointing authority/ competent to sign this certificate.
Date:

Signature of Employer
Name:
Designation:
Official Seal:

Certificate of Completion of Academic Requirements of Qualifying Degree

(Format of the Certificate to be submitted by the candidates whose results of qualifying examination are not
declared. This certificate must be signed by the Dean/ Principal/ Registrar/ Director of the Institution where the
candidate has studied for qualifying examination.)
This is to certify that Mr./Ms. (Name of the Candidate) (Examination Roll No.) has
appeared in the final examination of (Name of examination) ..in the (Discipline) ..
(including all papers in theory, practical, Project, oral, etc.) in all subjects and has no back papers for any semester/
year in which he/ she is yet to appear. He/she has submitted the M.E./M.Tech. thesis/dissertation (applicable only for
M.E./M.Tech. examination). He/ She is only waiting for the results, which have not yet been declared by the
University/ Institute.
(Signature and Name of the Signing Authority)
Date:
Designation:
Name of the Institute:

GENERAL INSTRUCTIONS FOR ADMISSION

1.

The candidates should read carefully the information in the PG Admission Notice available on the
website before filling the form.

2.

The candidates are required to fill in the complete details in the various columns. They should not
leave any space blank.

3.

If any candidate who fails to appear in counselling/interview his/her case will not be considered for
admission at later stage. Physical presence is absolutely necessary.

4.

The in-service candidates must forward application through their employer. They may send one advance
copy; however, the through-proper-channel copy shall invariably reach by the date of counselling otherwise
their candidature shall not be considered.

5.

The candidates are required to attach the following documents along with the application form. The
following check list must be completed.

Check List (Write Yes/No/ N.A.)

Demand Draft of requisite amount for application fee
Certificate of Good Character
Certificate of Physical Fitness
Caste certificate issued by the competent authority
(if applying for reserved seats)
Certificate of Completion of Academic Requirements of Qualifying Degree
(in case the result is awaited)
Attested copy of secondary school mark sheet
Senior secondary mark sheet
Undergraduate (B.E./B.Tech.) mark sheet
Post graduate (M.E./ M.Tech.) mark sheet
Valid GATE score card (if applicable)
Experience certificate (in case of candidate already in employment)
Form-16 issued by the employer in support of above for the period of
experience
For Sponsored Candidates
Sponsorship certificate
Form-16 issued by the employer in support of experience period
Appointment letter