Professional Documents
Culture Documents
First Year SS
First Year SS
First Year SS
You are informed that you have been provisionally selected for the B.E / B.Tech
Degree Course at Coimbatore Institute of Technology, Coimbatore. The admission is valid and final
only after the establishment of complete eligibility by the actual verification of all certificates in original
and subject to the approval of the Directorate of Technical Education and the Anna University. You should
be present with all your original certificates and fees for admission on by 9 .00 a.m/11.00 a.m / 2.00
p.mat the Auditorium of the Institute.
Failure to join the Institute by the time fixed for admission or Submission of any
adverse certificate or non production of original certificateswill result in the cancellation of your admission.
The fees, once paid, will not be refunded. No extension of time for admission will be granted
under any circumstances.
PRINCIPAL
The following documents in original should be produced at the time of admission
4. Transfer Certificate and Conduct Certificate (From the Head of the Educational Institution in which the
candidates last studied).
5. Original Community Certificate card with Gopuram seal (For candidates other than OC).
7. Student‟s particulars form (Affix one passport size photo of student, Father & Mother in appropriate space).
All the applicants are informed that the original certificates produced at the time of admission will be retained in the
institute and will not be returned till the completion of the course under any circumstances whatsoever. To meet any
need for the certificates for scholarships , Education loans, application to other institutions etc.,the students are
advised to take atleast Ten(10)photo copies of allotment order, 10th mark sheet , +1 mark sheet , +2 mark sheet &
Community Certificate , First Graduate Certificate , Joint Declaration form , get them attested and produce the same
during admission.
IMPORTANT NOTE
The candidates should ensure that correct marks are furnished by him/her in the application form. The candidates are
informed that if, after proper scrutiny of his / her marks, it is found that the marks furnished by him / her in the
application form are not correct, then:
1.He / She will forfeit the admission no matter at what stage of the course he/she is at that time.
2.He / She will be debarred from pursuing the studies for a period of three years.
3.Legal action will be initiated against him/her for furnishing wrong marks.
We are aware of the above stipulated conditions for admission and accept to abide by the same
Father
The candidates are advised to produce five(5) attested copies of Allotment order (TNEA 2023) +2 Mark sheet , +1
Mark sheet , 10th Mark sheet , Transfer Certificate & Community Certificate , First Graduate Certificate (if applicable) in
addition to the above
* Scholarship Forms, Fee Concession Forms.,can be had from the office (Scholarship Section)
Signature :
Verified
Name :
COIMBATORE INSTITUTE OF TECHNOLOGY
(Government Aided Autonomous Institution affiliated to Anna University)
COIMBATORE – 641 014
STUDENT’S PARTICULARS 2023 – 24
(FILL IN BLOCK LETTERS)
Name :
Occupation :
Relationship :
Address :
3. a) Nativity b) Religion
i) Village c) Caste
ii) Taluk d) Community :SC/ST/MBC/BC/Others
iii) District e)Mother Tongue
f) Blood Group
h) Scholarship, if any , give details
4. a) Name of Father & Mother: Occupation of Father & Mother :
Residential Address : Office Address :
b) Whether Gazetted / N.G.O. (In case of Govt. employee) c). Annual Income Rs
EDUCATIONAL DETAILS
Exam last Name &Place of University / Month / Year of Reg.No T.M.R.Code No.(as No.of
passed Institution Board passing entered in the Attempts
H.S.C.Mark list)
Subject Marks (out of 100) Percentage % of Physics & Chemistry Marks obtained (out of 200) % of
put together M+% of P+C put together
Maths (M)
Physics (P)
Chemistry (C)
6. Student Mobile No :
7. Student E – mail ID :
I do hereby declare that the above said details furnished by me are complete and correct to the
best of my knowledge.
furnished by me are true, correct and complete. Otherwise, I will be liable to forfeit my seat and / or
removed from the rolls of the Institution at whatever stage of study, besides making me LIABLE FOR
CRIMINAL PROSECUTION.
Principal: Date:
ANNEXURE – 1
S/o-D/o . of Mr./Mrs./Ms
1. Having been admitted to Coimbatore Institute of Technology, have received a copy of the
2009, (here after called the “ Regulations”) carefully read and fully understood the provisions
constitutes ragging
3. I have also, in particular , perused clause 7 and clause 9.1 of the Regulations and I am fully
aware of the penal and administrative action that is liable to be taken against me in case I am
promote ragging.
a) I will not indulge in any behaviour or act that may be constituted as ragging under
5. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1
of the Regulations, without prejudice to any other criminal action that may be taken against me
under any penal law or any law for the time being in force.
6. I hereby declare that I have not been expelled or debarred from admission in any Institution in
the country on account of being found guilty of , abetting or being part of a conspiracy to
promote, ragging ; and further affirm that, in case the declarations is found to be untrue. I am
Name
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of
the affidavit is false and nothing has been concealed or misstated therein
Signature of Deponent
ANNEXURE – 2
enrolment number)
1. Having been admitted to Coimbatore Institute of Technology, have received a copy of the
AICTE regulation on Curbing the menance of Ragging in Higher Education Institutions , 2009,
(here after called the “ Regulations”) carefully read and fully understood the provisions
contained in the said Regulations.
3. I have also, in particular , perused clause 7 and clause 9.1 of the Regulations and I am fully
aware of the penal and administrative action that is liable to be taken against my ward in case
he/she found guilty of or abetting ragging , actively or passively, or being part of a conspiracy
to promote ragging.
c) My ward will not indulge in any behaviour or act that may be constitute as ragging
under clause 3 of the Regulation
d) My ward will not participate in or abet or propagate through any act of commission
or omission that may be constitute as ragging under clause 3 of the Regulations
5. I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to
clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken
against me under any penal law or any law for the time being in force.
6. I hereby declare that I have not been expelled or debarred from admission in any Institution in
the country on account of being found guilty of , abetting or being part of a conspiracy to
promote, ragging ; and further affirm that, in case the declarations is found to be untrue. I am
Signature of Deponent
Name
Address:
Telephone/mobile No:
VERIFICATION
Verified that the contents of this affidavit are true to the best of my knowledge and no part of the
Signature of Deponent
His / Her age according to his / her own statement is years and by
Height cm weight kg
Acuteness of Vision L R
In case where sight is corrected with glasses, the power of glasses for each eye should be mentioned.
Station : Name
Date : Rank
Designation :
1. Applicant
2. Father
3. Mother
4. Father‟s Father
5. Father‟s Mother
6. Mother‟s Father
7. Mother‟s Mother
8. Brother / Sister
9. Brother / Sister
I hereby solemnly and sincerely affirm that I am the first person from my family to claim the
waiver of Tuition Fee for entire Professional Course of study and there is no graduate in my family so
far. The particulars furnished above are true. If it is found that any information furnished therein is false
later on verification at a stage, I am liable for criminal prosecution and I also agree to return the amount
equal to three times the tuition fee waiver availed by me.
Date :
Place :
SIGNATURE OF THE CANDIDATE
I solemnly and sincerely affirm that I am fully aware of the above declaration and the particulars
furnished in the declaration are correct. I am liable for the criminal action / recovery of amount equal to
three times of the fees waived, for incorrect particulars furnished.
Date :
Place :
NAME
TNEA APPLICATION NO
STUDENT ID (TNEA)
Amount payable HSC / CBSE / GOI / OTHER STATE
Rs.83,100/-
Self supporting courses B.E / B.Tech
B.Tech (AI &DS) Rs.78,100/-
Candidate’s Signature