Office : 0484 2463825

Fax
: 0484 2463828

ADI SHANKARA INSTITUTE OF ENGINEERING &

TECHNOLOGY
(AN ISO 9001: 2008 CERTIFIED INSTITUTION)
(Affiliated to Mahatma Gandhi University, Kottayam)
Vidya Bharathi Nagar, Kalady 683574

DL

Post Box No. 1, Ernakulam Dist., Kerala.

E-mail : adishankara.net@gmail.com
Website : www.adishankara.ac.in

APPLICATION FOR ADMISSION TO THE B.TECH DEGREE COURSES 2015 2019

(Under NRI Quota)
Courses Offered :
a Applied Electronics & Instrumentation
b Computer Science & Engineering
c Electronics & Communication
d Electrical & Electronics
e Information Technology
f Mechanical Engineering
g Civil Engineering

RECEIPT NO. ...

Name of the Applicant (in Block

Letters)

a) Sex
b) Religion & Caste
c)

Place of Birth
(Village/Town, District, State)

d) Age & Date of Birth

i)
2

Branch Sought for in the order of

priority

Details of Engineering Entrance Examination

State Entrance Exam Roll No. of

the Applicant
State Entrance Rank No. of the
b)
Applicant
Marks secured in the Entrance
c)
Examination
Name, Occupation & Address
Of Parent / Guardian
4
Phone No.
Mobile No.
Address for Communication
5
(in Block letters with Pin Code)
Contact Phone Number with STD
6
Code
a)

ii)

Academic Details (Attach attested copies of Mark Sheets, including marks

obtained)
Percentag
Name of
CBSE/ICS Mathemati
Physics
Chemistry
e
Examination passed
E/ State
cs
(PCM)
7

Plus two
Name of the
Institution last
studied (+2 Exam or
Equivalent)

Total Marks
For +2

Percentag
e

Total Marks obtained

in 10th Examination

10 Recommendation if
any
Do you require
11 Hostel
Accommodation?
Attach Photo copies
of extracurricular
12
activities & prizes
won
Do you require Bus
facility
13
if yes from where

Declaration :
I hereby declare that the particulars given in this form are true, complete and
correct to the best of my knowledge and belief.
Place :
Date :
the Applicant

Signature of Guardian

Signature of

The duly filled in application form should reach the Principal before the stipulated
date
The following documents are essential (only copies)
1. 10th Mark List
2. +2 or equivalent mark list
3. Entrance Rank Certificate, Mark sheet & Admit Card
4. Income Certificate if scholarship is to be availed

For further details contact :

Managing Trustee
Kochi

Ph : 0484-2351768
Adi Sankara Trust
Vidya Bharathi Nagar, Kalady P.O.
Post Box No.1, Ernakulam Dist
Kerala, Pin : 683574

Ph:0484
2463825, 2461933, 2463828
Fax : 0484 - 2463828