Sr.No.

_______
Guru Nanak Dev Engineering College
Ludhiana – 141 006.
___________________________________________________________________________________________________________
APPLICATION FORM FOR ADMISSION TO POST GRADUATE COURSE – M.Tech. (Full-Time/Part Time) 2010 - 2011
Self attested
Photograph

NAME OF COURSE ___________________________________________________________________

Name in full (Block Letters) Mr./ Ms.________________________________________________________

Father’s Name_______________________________Father’s Occupation___________________________

Mother’s Name______________________________Mother’s Occupation__________________________

Date of Birth________________________________Place of Birth________________________________

Present Address_________________________________________________________________________

_______________________________________________________________________________________

Permanent Addresss______________________________________________________________________

_______________________________________________________________________________________

Phone / Mobile No._________________________________E-mail________________________________

Married / Single __________________________ Nationality ___________________________________

Scheduled Caste / Tribe (Yes / No)_____________________(If Yes, attach certificate)_______________

B.Tech. or equivalent ____________________________________________________________________

Year of Passing ________University__________________________College________________________

Demand Draft No.____________________dated_______________________for Rs._________________

Academic Qualifications :-

Name of Name of Name of Univ. Year of Subjects Marks % age of

Examination Univ. College** Roll Passing Obtained / Marks
No. Total Marks

Matriculation

B.Tech. or
Equivalent
i.e. AMIE etc.

** Is the College / Department of the University from where you have graduated approved by AICTE? (Yes / No).

Experience (attach document)

Sr.No. Name & Address of Employer/Institution Nature of work Period
1.

2.

3.

4.

I hereby certify that the entire information furnished by me in this form is true and correct and has been entered correctly to the best of my
knowledge and belief.
I further hereby undertake that I have drawn/not drawn any Post-Graduate scholarship till date (Delete what is not relevant).

Date_____________

Place_____________ (Candidate’s Signature)

Certificate by Parents’/Guardian

I certify that my son/daughter/ward____________________ is applying with my knowledge and that I hold myself responsible for
his/her good conduct and for maintenance and payment of his/her dues during his / her stay at the College.

Date_____________

Place____________ (Parent/Guardian’s Signature)