Mtech Form
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Website Version For Office use Recommended for admission Head of the Department/
Form No………………… Sold by ……………….. Self Attested photo
Course Co-ordinator
UNIVERSITY OF CALCUTTA UNIVERSITY COLLEGE OF SCIENCE, TECHNOLOGY AND AGRICULTURE APPLICATION FORM FOR ADMISSION TO FIRST YEAR M.TECH./M.PHIL. COURSES
To The Secretary Faculty Councils for P.G. Studies in Sc., Tech.& Engg and Ag. & Vet. Sc. Calcutta University 92, A.P.C. Road, Kolkata – 700 009 Name of the Applicant (in block letters): __________________________________________________ Applied for Admission in Course: ____________________________Session:__________________ Subject: ____________________________________________________ Bachelor’s Degree in Engg./Tech. or M.Sc. with Subject: _____________________________________ College and University: _______________________________________________________________ Year of Entry in BE/B.Tech/ M.Sc.: __________________________ Year of Passing: ______________ GATE Score, if any _______________________________ Year_______________________________ Whether admitted earlier in this course, give details: ________________________________________ Date of Birth: ________________ Whether Employed: ______________________________________ Category: GEN SC ST PH Statement of marks in Bachelor’s degree in Engg / Tech or M.Sc. examination: Examination
Semester / Part
SGPA
CGPA
Total marks obtained
Total marks of exam
Class/Div.,
% of marks
I II III IV V VI VII VIII Statement of marks in the following Examinations: Examination
Board/ University
Year of passing
Total marks obtained
Full marks of exam.
Grade/ GP
Class /Div.
% of marks
Madhyamik or equiv. (10) HS or equivalent (10+2) B.Sc.(Hons.) (10+2+3) Diploma in Engg./ Tech
For Website Version form: C.U. Cash Challan No_________________ Date___________________ Or DD.No.________________ Date_____________ Issuing Bank_____________________________ (In reverse of DD, Please write the name and course applied for)
WEBSITE VERSION
UNIVERSITY COLLEGE OF SCIENCE, TECHNOLOGY AND AGRICULTURE 1. 2. 3.
4.
5. 6. 8. 9. 10. 11. 12. 13. 14.
Name of the applicant (in block letters)……………………………………………………………………………… Calcutta University Registration No.(for C.U.Students)…………………………………………………………….. Present address (if any) ……………………………………………………………………………………………… …………………………………………………………………………………………….. …………… …………………………………………………………………………………. Telephone No……………….……Mobile………………………………..Email :………………………………….. Permanent address . .…………………………………………………………………………………………………. ……………………………………………………………………………………………………. …………………………………………………………………………………………………… ……………………………………………………… Telephone No……………………………. Nationality ……………………………………. Domicile state …………………………………………………… Male / Female …………………………….…… 7. Married / Unmarried………………………………………. Father’s Name …………………………………………... Occupation …………….. Monthly Income …………. Mother’s Name ………………………………………..… Occupation …………….. Monthly Income ………….. Husband’s /Wife’s name ………………………………… Occupation …………….. Monthly Income ………… Guardian’s name, relationship and occupation ……………………………………………………………………. Income of the family per month ………………………………………………… Are you enjoying any scholarship or stipend (if yes, state the name of the sponsor) : ………………………………… Details of employment (if employed)
……………………………………………………………………………………………………………………………….
DECLARATION / UNDERTAKING I do here by declare / undertake that the statements made above by me are true. If any error/misinformation is detected after my provisional admission, my admission shall be treated as cancelled. I have not taken admission nor shall I take admission to any other course during my studies in this University without intimation. If I get admission I will be a full time student of this University (not applicable for part-time courses). If I remain absent from the classes continuously for seven days or intermittently for more than 50% of classes held during any two consecutive weeks, my studentship will be terminated and my name will be automatically struck off from the rolls according to the admission rules of the University. Endorsed ____________________________________ Signature of Father/Mother/Husband/Guardian
Date ……………………. N.B. 1. 2. 3. 4. 5.
___________________________________ Signature of the Applicant
Date ………………….
Application must be accompany attested copies of all relevant Mark Sheets and Certificates as applicable For Sponsored candidates Employer Certificate in original must be attached to the application form. Attestation by C.U. Senate/Syndicate Member, any University Teacher/Officer, Principal of any College, any Teacher of a College Affiliated to C.U. or Gazzetted Officer accepted. All documents and photo submitted must be signed by the candidate himself/herself. Incomplete Forms are liable to be rejected.
RECEIPT PAGE WEBSITE VERSION
………………………………………………………………………………………………………. Form No…………… University Colleges of Science, Technology and Agriculture University of Calcutta
Received the application form without verification from………………………………….............. for the course………………………Subject……………………………………………………….
Date:
Signature
UNIVERSITY OF CALCUTTA
HALL
TICKET
Hall Ticket No._________
Admission Test for 2 Yr./3 Yr. M.Tech. Courses, 2009
Self attested stamp Size Photograph
Name (In Block Letters) :___________________________________________ Address : _______________________________________________________ __________________________Ph.No./Mobile.No.:______________________ Signature of Candidate ; ___________________________________________ VENUE : University College of Science & Technology, 92, A.P.C. Road, Kolkata – 700009
Date of Examination :
21.05.2009 2Yr. M.Tech in Elect. Engg. / 3Yr. M.Tech in Elect. Engg. (Elect. Power) Time..12 Noon to 1 P.M. 2Yr. M.Tech in Inst & Control. Engg. / 3Yr. M.Tech in Inst & Control. Engg Time..2P.M. to 3 P.M.
SECRETARY
Hall Ticket must be produced at the time of Examination
UCSTA, C.U
UNIVERSITY OF CALCUTTA
HALL
TICKET
Self attested stamp Size Photograph
Hall Ticket No._________
Admission Test for 2 Yr./3 Yr. M.Tech. Courses, 2009 Name (In Block Letters) :___________________________________________ Address : _______________________________________________________ __________________________Ph.No./Mobile.No.:______________________ Signature of Candidate ; ___________________________________________ VENUE : University College of Science & Technology, 92, A.P.C. Road, Kolkata – 700009
Date of Examination :
21.05.2009 2Yr. M.Tech in Elect. Engg. / 3Yr. M.Tech in Elect. Engg. (Elect. Power) Time..12 Noon to 1 P.M. 2Yr. M.Tech in Inst & Control. Engg. / 3Yr. M.Tech in Inst & Control. Engg Time..2P.M. to 3 P.M.
SECRETARY
Hall Ticket must be produced at the time of Examination
UCSTA, C.U
Form No………………… Sold by ……………….. Self Attested photo
Course Co-ordinator
UNIVERSITY OF CALCUTTA UNIVERSITY COLLEGE OF SCIENCE, TECHNOLOGY AND AGRICULTURE APPLICATION FORM FOR ADMISSION TO FIRST YEAR M.TECH./M.PHIL. COURSES
To The Secretary Faculty Councils for P.G. Studies in Sc., Tech.& Engg and Ag. & Vet. Sc. Calcutta University 92, A.P.C. Road, Kolkata – 700 009 Name of the Applicant (in block letters): __________________________________________________ Applied for Admission in Course: ____________________________Session:__________________ Subject: ____________________________________________________ Bachelor’s Degree in Engg./Tech. or M.Sc. with Subject: _____________________________________ College and University: _______________________________________________________________ Year of Entry in BE/B.Tech/ M.Sc.: __________________________ Year of Passing: ______________ GATE Score, if any _______________________________ Year_______________________________ Whether admitted earlier in this course, give details: ________________________________________ Date of Birth: ________________ Whether Employed: ______________________________________ Category: GEN SC ST PH Statement of marks in Bachelor’s degree in Engg / Tech or M.Sc. examination: Examination
Semester / Part
SGPA
CGPA
Total marks obtained
Total marks of exam
Class/Div.,
% of marks
I II III IV V VI VII VIII Statement of marks in the following Examinations: Examination
Board/ University
Year of passing
Total marks obtained
Full marks of exam.
Grade/ GP
Class /Div.
% of marks
Madhyamik or equiv. (10) HS or equivalent (10+2) B.Sc.(Hons.) (10+2+3) Diploma in Engg./ Tech
For Website Version form: C.U. Cash Challan No_________________ Date___________________ Or DD.No.________________ Date_____________ Issuing Bank_____________________________ (In reverse of DD, Please write the name and course applied for)
WEBSITE VERSION
UNIVERSITY COLLEGE OF SCIENCE, TECHNOLOGY AND AGRICULTURE 1. 2. 3.
4.
5. 6. 8. 9. 10. 11. 12. 13. 14.
Name of the applicant (in block letters)……………………………………………………………………………… Calcutta University Registration No.(for C.U.Students)…………………………………………………………….. Present address (if any) ……………………………………………………………………………………………… …………………………………………………………………………………………….. …………… …………………………………………………………………………………. Telephone No……………….……Mobile………………………………..Email :………………………………….. Permanent address . .…………………………………………………………………………………………………. ……………………………………………………………………………………………………. …………………………………………………………………………………………………… ……………………………………………………… Telephone No……………………………. Nationality ……………………………………. Domicile state …………………………………………………… Male / Female …………………………….…… 7. Married / Unmarried………………………………………. Father’s Name …………………………………………... Occupation …………….. Monthly Income …………. Mother’s Name ………………………………………..… Occupation …………….. Monthly Income ………….. Husband’s /Wife’s name ………………………………… Occupation …………….. Monthly Income ………… Guardian’s name, relationship and occupation ……………………………………………………………………. Income of the family per month ………………………………………………… Are you enjoying any scholarship or stipend (if yes, state the name of the sponsor) : ………………………………… Details of employment (if employed)
……………………………………………………………………………………………………………………………….
DECLARATION / UNDERTAKING I do here by declare / undertake that the statements made above by me are true. If any error/misinformation is detected after my provisional admission, my admission shall be treated as cancelled. I have not taken admission nor shall I take admission to any other course during my studies in this University without intimation. If I get admission I will be a full time student of this University (not applicable for part-time courses). If I remain absent from the classes continuously for seven days or intermittently for more than 50% of classes held during any two consecutive weeks, my studentship will be terminated and my name will be automatically struck off from the rolls according to the admission rules of the University. Endorsed ____________________________________ Signature of Father/Mother/Husband/Guardian
Date ……………………. N.B. 1. 2. 3. 4. 5.
___________________________________ Signature of the Applicant
Date ………………….
Application must be accompany attested copies of all relevant Mark Sheets and Certificates as applicable For Sponsored candidates Employer Certificate in original must be attached to the application form. Attestation by C.U. Senate/Syndicate Member, any University Teacher/Officer, Principal of any College, any Teacher of a College Affiliated to C.U. or Gazzetted Officer accepted. All documents and photo submitted must be signed by the candidate himself/herself. Incomplete Forms are liable to be rejected.
RECEIPT PAGE WEBSITE VERSION
………………………………………………………………………………………………………. Form No…………… University Colleges of Science, Technology and Agriculture University of Calcutta
Received the application form without verification from………………………………….............. for the course………………………Subject……………………………………………………….
Date:
Signature
UNIVERSITY OF CALCUTTA
HALL
TICKET
Hall Ticket No._________
Admission Test for 2 Yr./3 Yr. M.Tech. Courses, 2009
Self attested stamp Size Photograph
Name (In Block Letters) :___________________________________________ Address : _______________________________________________________ __________________________Ph.No./Mobile.No.:______________________ Signature of Candidate ; ___________________________________________ VENUE : University College of Science & Technology, 92, A.P.C. Road, Kolkata – 700009
Date of Examination :
21.05.2009 2Yr. M.Tech in Elect. Engg. / 3Yr. M.Tech in Elect. Engg. (Elect. Power) Time..12 Noon to 1 P.M. 2Yr. M.Tech in Inst & Control. Engg. / 3Yr. M.Tech in Inst & Control. Engg Time..2P.M. to 3 P.M.
SECRETARY
Hall Ticket must be produced at the time of Examination
UCSTA, C.U
UNIVERSITY OF CALCUTTA
HALL
TICKET
Self attested stamp Size Photograph
Hall Ticket No._________
Admission Test for 2 Yr./3 Yr. M.Tech. Courses, 2009 Name (In Block Letters) :___________________________________________ Address : _______________________________________________________ __________________________Ph.No./Mobile.No.:______________________ Signature of Candidate ; ___________________________________________ VENUE : University College of Science & Technology, 92, A.P.C. Road, Kolkata – 700009
Date of Examination :
21.05.2009 2Yr. M.Tech in Elect. Engg. / 3Yr. M.Tech in Elect. Engg. (Elect. Power) Time..12 Noon to 1 P.M. 2Yr. M.Tech in Inst & Control. Engg. / 3Yr. M.Tech in Inst & Control. Engg Time..2P.M. to 3 P.M.
SECRETARY
Hall Ticket must be produced at the time of Examination
UCSTA, C.U
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