APPLICATION FORM NO:

PEC UNIVERSITY OF TECHNOLOGY, CHANDIGARH

APPLICATION FORM$ FOR ADMISSION TO ME DEGREE COURSE (For filling this application form see instructions overleaf) To be filled in by the office Diary No.
1. Full Name :
3. Place of Birth:

Date:

Signature:

Paste your Photograph Here

2. Date of Birth : 5. Marital Status: 7. 8. Fathers Name : Address for Correspondence:

4.

Sex: Male/Female

6. Nationality:
Codes for Items 11-15 are given overleaf

11. Programme

State: 9. If available, please provide: Phone No. : E-mail address:

Pin Code : Fax No. :

12. Category 13. Student Status 14. Sponsorship Status 15. Physically Handicapped

10. Details of Demand Draft(for photocopied/ website downloaded form) a) Amount Rs. No. .. dt. .. b) Bank & Branch issued .... 16. Academic Record/Work Experience A. GATE exam details (*) Exam Name Exam discipline Score Exam Year

B. Qualifying Degree (*) already obtained or in progress

University/Institute Discipline Degree Exam Date Final results expected by Min. Pass Marks % or Grade Average

% Marks or Grade Point Average

Sem. I

Sem. II

Sem. III

Sem. IV
Overall % or Grade Average (if degree completed)

Sem. V

Sem. VI

Sem. VII

Sem. VIII

C. Other Degrees (*) obtained after 10+2 (Do not include the degree listed in 16 B) University/Institute Discipline Degree Marks Date of completion

D. Working Experience (**)

Dates (from-to) Name & Address of Employer Position Nature of Work

($) Copies downloaded from the PEC University of Technology website (http://www.pec.ac.in) are acceptable. The downloaded
application forms are to be accompanied by a fee of Rs.1000/- (Rs.500/- for SC/ST/Physically handicapped candidates) in the form of a draft. In case a student is applying to more than one programme, photocopied forms can be used. In that case each additional form must be accompanied by a fee of Rs.100/-. All forms submitted by the candidate must be received under the same cover. The total fee may be paid through a single draft. In favour of Director PEC University of Technology, Chandigarh (*) Attach attested copies of certificates, mark sheets etc. See checklist overleaf for certificates required. (**) A candidate presently working (including those on projects) must provide a No Objection/Relieving Certificate from the employer.
() In case the result is given in grade points an authenticated copy of formula for conversion to % marks should be attached.

17. Declaration by the applicant: (a) I hereby certify that the entries made by me in this form are correct to the best of my knowledge & I have not suppressed any information in any manner. (b) I agree to observe & abide by all the rules & regulations of the institute & the hostel that may be laid down from time to time by the PEC University of Technology, Chandigarh during the period of my studies & training & not to associate myself with any activity prejudicial to the discipline of the institution. (c) I fully understand that for any violation or infringement of these rules & regulations, disciplinary action can be taken against me by the authorities. (d) I hereby solemnly affirm & declare that I have never been disqualified by any Board/University or convicted on any account. (e) I understand that if at any stage it is found that I have provided any wrong information or have suppressed any information to seek admission to this institute, my admission shall automatically stand cancelled and I will have no claim on the seat or the dues paid to the institute. Date: ________ Signature: __________________________ INSTRUCTIONS FOR FILLING THIS FORM
1. 2. 3. Either TYPE or PRINT the entries on the form neatly. Go through the codes for Items 11-15 given below, and fill them carefully in the boxes on Page 1. All items marked with an asterisk (*) require you to submit an attested copy of a supporting document. PLEASE DO NOT SEND ORIGINALS. Documents for which attested copies are required are given in the checklist. Please tick off the items in the checklist you are attaching to this form.

CODES (FOR ITEMS 11-15)

Item 11: Programme Codes: {Highways Engg.=HIG}, {Irrigation & Hydraulics Engg.=IRR},{Structural Engg.=STR},{Environmental Engg.=ENV}, {Electrical Engg. = ELE},{Mechanical Engg. = MEC}, {Electronics=ECT}, {Industrial Materials & Metallurgical Engg. = IMM}, {Production & Industrial Engg. = PRO}, {Computer Science & Engg.. = CSE}, {Computer Science & Engg.(Information Security). = CSE(IS) }, {Total Quality Engineering & Management (TQE)}, { Industrial Design(IDE)} Item 12: Category SC* : Scheduled Caste (certificate required); ST* : Scheduled Tribe (certificate required); GN : General; Item 13: Student Status : Full Time : FT; Part-Time : PT Item 14: Sponsorship Status : Sponsored (*) : SD; Non-Sponsored: NS Item 15: Physically Handicapped : PH (Physically handicapped certificate Clearly mentioning % of disability) Format of Sponsorship Certificate (form I) is attached.

CHECKLIST (CIRCLE THE ENCLOSED DOCUMENTS). SEND ONLY ATTESTED COPIES (NOT ORIGINALS).
1. 2. 3. 4. 5. 6. 7. 8. 9. Date of birth (DOB) certificate or High School (Class Ten) Certificate with DOB (Required for all candidates) SC/ST Certificate if applicable (Item 12) Certificate of Physical Handicap (Type of disability to be attached). Sponsorship Certificate for sponsored candidates (Item 14) Form I GATE score card (Item 16 A) Copies of mark/grade sheets (Items 16 B & 16C) No Objection/Relieving Certificate from employer (for employed candidates) Migration Certificate from the institute attended last Undertaking from the institution attended for the non-declaration of result of the last semester / having appeared in last semester as per format given in this application form. 10. The Demand Draft for application fees

The completed Application Form must reach The Officer-in-Charge PG Admissions PEC University of Technology Chandigarh-160012 (Name of Parent Department should be superscribed on the envelope)

Annexure-A FORMAT FOR CERTIFICATE OF SPONSORSHIP FOR NOMINEES Certified that ______________________________________________________ son/daughter of Shri_____________________________________ has been working as_____________________________ (Engineer/Teacher) on regular whole time basis in_______________________________

(Department/Organization) since____________________(date). His/her name is hereby sponsored for admission to M.E. Degree Programme in* _______________________________________ Engineering at PEC University of Technology, Chandigarh for the session______________________. In case he/she is selected for admission, he/she will be relieved of his/her duty and allowed to join the classes for full duration of the said programme. If he/she leaves this Department/Organization during his/her period of study, PEC University of Technology will be informed accordingly to cancel his/her admission. Further certified that he/she shall continue to be an employee of this Department/Organization and shall join back his/her duties after completing the programme. Certified that this institute is approved by AICTE (only for an educational Institute).

Date: _____________________ * Both the branch and the department should be mentioned.

_____________________________________ (Signature & Seal of the employer)

Annexure-B

CERTIFICATE FOR APPEARING IN THE FINAL SEMESTER/YEAR EXAMINATION (Required from candidates who are yet to appear in the qualifying examination)

I hereby certify in connection with the application of Mr./Ms. ___________________________________ that he/she is a bonafide student of our institution and is applying for admission to PG programme(s) at PEC University of Technology, Chandigarh. He / She is yet to complete the requirements of qualifying examination including theory, practical and project examination for B.E./B.Tech./M.Sc./MCA _____________________ (Strike out the non-applicable ones and write in the blank space if the degree is not mentioned) and the result is likely to be announced by ______________ 2011. The percentage of aggregate marks/CGPA obtained by him/her upto pre-final semester / year examination (Strike out the nonapplicable) is __________________. His/her conduct and character during his/her stay at the Institute / University is GOOD.

Place: _________________ Date: _________________

Signature of the Principal/Dean/Registrar/ Dy. Registrar/Proctor/Administrative Officer/ Asstt. Registrar of the institute attending/last attended with seal

Annexure-C CERTIFICATE FOR NON-DECLARATION OF RESULT (Required during registration from candidates whose result of the qualifying examination has not been declared)

I hereby certify that Mr./Ms. _________________________________________ has appeared in the final year examination including theory, practical and project examination for

B.E./B.Tech./M.Sc./MCA________________ degree (strike out the non-applicable ones and write in the blank space if the degree is not mentioned) and the result is likely to be announced by _______________ 2011. The percentage of aggregate marks/CGPA obtained by him/her in the pre-final year/semester examination is __________________ . His/her conduct and character during his/her stay at the Institute/University/College was GOOD.

Place: _____________ Date: _____________

Signature of the Principal/Dean/Registrar/ Dy. Registrar/Proctor/Administrative Officer/ Asstt. Registrar of the institute last attended with seal

SCRUTINY FORM FOR ADMISSION TO M.E. COURSES 2011 2012 (A separate copy of scrutiny form is to be filled for each application submitted by the candidate) Diary / Application No._______________ (to be filled by the office) PART A (to be filled by the candidate and to be checked by the scrutiny officers) 1. 2. Name___________________________________________________________________________________ M.E. Programme applied for; (a) ____________________________________________________ (b) ____________________________________________________ (c) ____________________________________________________ (d) ____________________________________________________ 3. 4. Category: _________________________________Gen (GN) /SC / ST / Sponsored (SD) / Handicapped (PH)/PT Name of the qualifying examination passed (BE / B.Tech/MCA/AMIE / IETE etc.), branch of engineering/science, and the university_________________________________________________________________________________

5.

Marks secured Section AMIE / IETE Graduates Secured / Max. marks

B.E./ B. Tech./MCA Secured marks/Max. marks

______________/___________marks

Section A Section B Aggregate of Sections A and B: Percentage:

6. Whether qualified in GATE? If yes, % score & Year_______________________________

CERTIFICATES ATTACHED WITH THE APPLICATION FORM (No separate certificates are to be attached with the scrutiny form)
1 2 3 4 5 6 7 8 9 Date of birth (DOB) certificate or High School (Class Ten) Certificate with DOB SC/ST Certificate Certificate of Physical Status (Type of disability to be attached) Sponsorship certificate for sponsored candidates GATE score card Copies of mark/grade sheets No Objection/relieving Certificate from employer (for employed candidates) Migration certificate from the institute attended last Undertaking from the institution attended for the non-declaration of result of the last semester / having appeared in last semester as per format given in this application form.

Note: Circle the enclosed documents. . Signature of the candidate

PART - B (To be filled by the Scrutiny Officers)

7. Is the degree from an AICTE approved college/ university or recognized by UGC. 8. GATE qualified: 9. GATE Score: B.E./B.Tech./MCA Score: For AMIE / IETE candidates: (i) Whether passed Diploma before AMIE / IETE: (ii) Whether possesses 5 years experience: 10. For Sponsored/Part-time candidates: Whether possesses requisite 2 years experience in the sponsoring organization: 11. If physically handicapped, whether medical certificate attached 12. Whether ELIGIBLE / INELIGIBLE:

YES / NO YES / NO

YES / NO YES / NO

YES / NO YES / NO

13. Reasons if ineligible:__________________________________________________________ 14. Deficient Documents, if any: ___________________________________________________ ____________________________________________________ 15. Any other remark: ___________________________________________________________ ____________________________________________________________

______________ Scrutiny officer (I)

________________ Scrutiny officer (II)

PEC UNIVERSITY OF TECHNOLOGY, CHANDIGARH No. PEC/Stds-5/P.G. Admn./___________ Dated:

1. Your application for admission to the M.E. Degree Programme at this institute has been received and entered at Sr. No.____________________ in the Register. 2. For all further correspondence with this office, you should quote the Sr. No. mentioned above with the following particulars. i. Branch / Specialization ii. Category against which applied for

For Officer-in-Charge PG Admissions, PEC University of Technology, Chandigarh.

[Write Your Address here legibly]

Affix Postage Stamp

To ____________________________________________________

_____________________________________________________ _____________________________________________________