PGECET Hall Ticket No. General Rank
( To be filled in English by the candidate )
1. (a) Name ( In block letters as per S.S.C Record )
(b) Father's Name ( In block letters as per S.S.C Record )
(d) Date of Birth (c) Gender Male Female
(e) Religion (f) Caste
(g) Nationality (h) Mother Tongue
(i) Place of Birth
Country State Village/Town
(j) Community status OC OC-EBC BC A B C D SC ST (k) Blood Group
(l) Supernumerary Status PH Ex-servicemen NCC NSS Sports
2. Address for Communication (a) Permanent
Pin
Phone Mobile Residence O ffice
(b) Local Pin
Student Email Father/Gaurdian Email
AFFIX YOURLATEST
PHOTOGRAPH
www.nri.edu.in
NRI INSTITUTE OF TECHNOLOGYKothur, Near Gudur Gate, Kandukur Mandal, Srisailam Highway, R.R.Dist, Greater Hyderabad-501 359.Ph: 08414-235 201/2/4, Fax: 08414-235 203. Mobile: 91776 00038. e-mail: [email protected]
APPLICATION FORM
For Admission to M.Tech Course Academic year
Academic Year: 201 - 201
M.Tech Specialization:
FORM No.: REGISTRATION No.:
NRI
Management
Counselling
Spot
Marks Subject
TYPE OF ALLOTMENT:
IMPORTANT NOTE: a) Incomplete application will not be considered.
b) The candidate or parent must be in touch with the administrative office of college to know the
result of selection and the last date for remittance of fee. The administrative office
takes no responsibility for communicating the information with regard to payment of
admission fee & submission of application form.
The Following Documents are to be submitted at the time of admission
Passport Size Photographs - 10
PGECET Documents - 2 Sets
1. Rank Card
2. Hall Ticket
3. Allotment Order
4. Fee Challan
Education Related Documents - 2 Sets
1. SSC Certificate
2. Intermediate Memorandum of Marks
3. B.Tech Consolidated Marks Memo / Provisional Certificate/OD
4. Study & Conduct Certificate - SSC, Intermediate/Diploma & B.Tech
5. Transfer Certificate
Fees Reimbursement Related Documents - 2 sets
1. MeeSeva Caste Certificate issued by the Competent authority in case of BC/SC/ST Candidates
2. MeeSeva Income Certificate from MRO
3.Aadhar Card
4. Ration / Voter ID Card
5. Bank Pass Book Front Page
Non-Local / Out of State Students - 2 Sets
1. Residence Certificate of Father / Mother for a period of 10 years in AP from MRO in case of non-local Candidates.
2. Migration Certificate
3. Equivalence Certificate from out of State Students (SSC&Inter)
NOTE:
1. The Application will not be considered, if the required Certificates are not enclosed.
2. Original Form to be submitted in College Office.
3. Duplicate Form to be Submitted in DEO-Hyderabad Office
FOR OFFICE USE ONLY:
1. Certificate copies of all the documents submitted by the candidate are checked.
2. Candidate is eligible for admission to M.Tech Course. His / Her admission is in accordance with the admission rules
ADMISSION INCHARGE DIRECTOR OF ADMINISTRATIONDATE OF ADMISSION
4. (a) Father's Name / Guardian’s Name
Qualification
Occupation
Place of work
(b) Mother’s Name
Qualification
Occupation
Place of work
(c) Fill the following only if you married
Spouse's Name
Qualification
Occupation
Place of work
Number of children
5. Total Annual Income
6. Academic Information:
S.S.C / ICSE / CBSE
Intermediate/Diploma
B.Tech
Any Other
(Tick on Appropriate item)
3. Identification Marks 1) 2)
PLACE:
DATE: Signature of Parent / Guardian
DECLARATION BY THE APPLICANT
I declare that all particulars furnished above are correct. I know that, Admission in this is subject to the cond i t ions la id
down by Jawaharlal Nehru Technological University and NRI Educational Society. If any of my statements
are found incorrect on scrunity, my admission may be cancelled at any time during the course of study. I have
not suppressed any information. I shall abide by the decision of the Management of NRI Institute of Technology.
On admission, I shall never demand for any refund of fees due to discontinuance of the course for any reason(s).
PLACE:
DATE: Signature of the Applicant
DECLARATION BY THE PARENT / GUARDIAN
I Certify that particulars furnished by my son / daughter / ward are correct, if any of these
statements are found in-correct in scrutiny, admission may be cancelled at any time during the
course of study. I shall be solely responsible for his/her conduct, good behaviour and
compliance with the rules enforced from time to time during the entire period of his / her
study in the college. The decision of the management of the college is final. In all matters,
I shall be responsible for the payment of the tuition fee and other fees prescribed by the college
management. I shall never demand for any refund of fees at any time due to discontinuance of
the course for any reasons(s)
Exam Registration No.
Name of the Institution attended
Year of passing
Medium of Instruction
Marks
Awarded DivisionQualification State
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