UNIVERSITY INSTITUTE OF ENGINEERING AND TECHNOLOGY

KURUKSHETREA UNIVERSITY KURUKSHETRA

APPLICATION FOR ADMISSION IN M.TECH. COURSE (2016-17)

COURSE APPLIED FOR : M.TECH._________________________________________________

(SUBMIT SEPARATE APPLICATION FOR EACH DEPT.)

FIRST CHOICE

____________________________

SECOND CHOICE ____________________________

COMPULSORY FOR CSE & MECHANICAL ENGINEERING ONLY

Registration No.
(for office use)

_________________________

DOB

___________________________

Candidate Name

_________________________

Gender

___________________________

Nationality

____________________________

Fathers Name

_________________________

Mothers Name

_________________________

Phone No.

____________________________

Resident

_________________________

Email

_____________________________

Street No.

_________________________

District

_____________________________

Village/Town

_________________________

State

______________________________

City

_________________________

Pin code

______________________________

Category

_________________________

DD Details

Amount___________Date_________
DD number_____________________
Payable at ______________________

Class

Board/University

Year of
Passing

Roll No.

Marks
Obtained

Total

Percentage

Matric
12th
B.Tech./B.E./
M.Sc. / MCA

Attach all the relevant documents and fees as per the checklist given in the M.Tech. Prospectus.
GATE Score
GATE Marks
GATE Validity up to

I declare that entries made by me in this Admission Application Form are true in all respects and in any case, any information is found
to be false, this shall entail automatic cancellation of my admission besides rendering me liable to such action, as the University may
deem proper.
I note that any admission to the University and my continuance on its rolls are subject to the provisions/rules of the University, issued
from time to time. I shall abide by the rules of discipline and proper conduct. I am fully aware of the law regarding ragging as well
as the punishment and that if found guilty on this account I am liable to be punished appropriately. I undertake that I shall not
indulge in any act of ragging.
Date

Signature

Take Printout of this application form and attach self-attested copies of relevant documents along with requisite fees and submit it to:
Director, University Institute of Engineering and Technology, Kurukshetra University, Kurukshetra-136118.
Kindly Mark APPLICATION FORM FOR M.TECH. on the top of Envelope.