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: office@nritech.edu.in

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