€ ~ MSIT MASTER OF SCIENCE IN INFORMATION TECHNOLOGY Consortium of Institutions of Higher Learning - Hyderabad APPLICATION FORM FOR ADMISSION TO 2-YEAR MSIT FOR THE YEAR 2009 Instructions ‘Application No 1. Last date for receipt of filled in Application 18th May, 2008. 2. Application should be accompanied by a non refundable demand draft of Rs 500 drawn in favour of “CHL, an a Scheduled Bank payable at Hyderabad, 3. The hal ticket for entrance examination will be Sent through F-mall on or before 22nd May, 2008. 4, For more deta vist our website wawnmnsitprogramvnet 1, Name of the Candidate (as in SSC or equivalent certificate) Paste your recent colour photograph here. DO NOT staple. 2. Nationality (Tick ¥) 3. Sex (Tick ¥) Indian Others Male Female| If not an Indian, country’s name 4, Date of Birth Day MONTH YEAR 5. Test centers: (choose any two in order of preference) Hyderabad Tirupati Visakhapatnarn| Vijayawada Warangal 6. Educational Qualifications: SIN. Name ofthe ] Year of | Educational | University) | Overall] Division/ Examination | Passing | Institution | Board | Percentage | Class 1. SSC or equivalent 2. Intermediate or equivalent 3. Graduation 4, Post Graduation 7. Complete Address for Correspondence of the Candidate Pin,9. GRE / TOEFL (If you have valid scores) GRE TOEFL Score Analytical Writing Quantitative Verbal Total Quantitative & Verbal Entrance Test Waived ‘@ Forcandidates with GRE cores above 1100/3.5 (GRE should havebeen taken after July 2006), ‘© Those candidates with TOEFL score above 213/300 (CBT) or79/120 (BT) would be exempted from taking the Listening Comprehension testin the stagell of the entrance test (TOEFL should have been taken after uly 2007). 10. Have you already taken the ‘Walk in Entrance Test’ If so, your Walk in ID 11. Phone No. STD code No 12. E-mail Id 13. Name of Parent / Guardian 14. Relationship to the Candidate (Tick “) Father Mother Other 15. DD details DD Number Date of Issue Bank Name Branch Name 16. Declaration by the Candidate I hereby declare that al the particulars furnished by mein this application are true, complete and correct. In case any information is found to be incorrect, my admission shal automatically stand cancelled, if admitted, besides rendering me liable to such action as ClHLmay deem fit. Place: Date: Signature of the Candidate For more information contact: The Dean, MSIT Programme Consortium of Institutions of Higher Learning IIIT Campus, Gachibowli, Hyderabad - 500032. Phones: 040-23001970, 040-65881971 email: enquiries2009@msitprogram.net www msitprogram.net