OFFICE OF THE CONTROLLER OF EXAMINATIONS

TEZPUR UNIVERSITY;NAPAAM( TEZPUR) ­784028

NOTIFICATION
F.11­13/ 1 /2007(Acad)/190
Dated 18th May, 2011
Applications in the prescribed format are invited from the candidates securing any of the top 10 ( ten)
positions in the higher secondary examinations conducted by the Board/Council of the North Eastern
States with at least 85% of marks in aggregate for Direct Admission to B. Tech. in Mechanical
Engineering/ Computer Science and Engineering/ Electronics and Communication Engineering/
Civil Engineering/ Food Engineering and Technology programme of his / her choice of discipline
with free studentship. The last date of receipt of such application is 15th June, 2011

Encl: Prescribed format

Sd/( B. Sahariah)
Controller of Examinations
 TEZPUR UNIVERSITY: NAPAAM (TEZPUR): ASSAM
Prescribed format for Direct Admission to B. Tech. programme: 2011­12
(For the candidates securing any of the top 10 ( ten) positions in the higher Secondary ( 10+2 level) Board/
Council examinations of North Eastern States)

1. Name of the candidate ( in Full Block letter) :

2. Father’s / mother’s name :
3. Permanent address :

4. Correspondence address :

5. Date and place of Birth :

( Please enclose a copy of the PRC)

6. Name and address of the institution last attended:

7. Marks secured in the HSLC ( 10th level ) examinations

· Total marks :
· Marks secured :
· Percentage of marks :
8. Position secured in the 10+ 2 level examinations of 2011:
9. Marks secured in the 10+2 level examinations :
· Total marks :
· Marks secured :
· Percentage of marks :
10. Have you filled in the application form of Tezpur University for admission: Yes / No
If yes, Pl. state the form no.:
11. Choice of discipline* in order of preference: 1. 2. 3. 4. 5.
12. Declaration to be signed by the candidates:
I declare that I shall abide by the Statutes, Ordinances, Rules, Orders etc of the University that will be in
force from time to time. I also declare that the information given above is true and complete to the best of my
knowledge and belief, and if any of it is found to be incorrect, my admission shall be liable to be cancelled and I
shall be liable to such disciplinary action as may be decided by the university.

Countersignature of the Parent/ Guardian with date Signature of the candidate with date
…………………………………………………………………………………………………………………………………………………………………………….
* Disciplines: (1) Computer Science and Engg. ( CSE) (2) Electronics and Communication Engg. (ECE), (3) Mechanical Engg. (ME) (4) Civil Engg. (CIV)
(5) Food Engineering Technology