National Institute of Food Technology Entrepreneurship and Management

Deemed to be University (De-novo Category) under Section 3 of the UGC Act, 1956 and an Autonomous Institution under Ministry of Food Processing Industries, GOI

Plot No 97, Sector 56, HSIIDC Industrial Estate, Kundli 131028, Dist. Sonepat, Haryana

Application Form for Admission to M. Tech. Programme 2012-13

For office use only Application No.: ............. Remark:.................................

Note: 1. The form should be filled neatly in English. All names should be filled in Capital Letters. 2. Admission obtained on ground of false/incorrect information is liable to be cancelled.

TICK (

) M. TECH. BRANCH(ES) IN WHICH ADMISSION IS SOUGHT

TICK

M.TECH. BRANCH Food Technology and Management Food Process Engineering and Management Food Supply Chain Management Food Safety and Quality Management Food Plant Operations Management and 1. Full name (In order of First, Middle and Last Name)

Paste recent colour Photograph (Passport Size)

________________________________________

2. Fathers name _______________________________________________________________________ 3. Mothers name________________________________________________________________________ 4. Date of birth (as per the certificate of class X) ___________________________________________ (dd - mm - yyyy)

5. a) Gender _______________b) State of Domicile ________________c) Nationality_________________ 6. Category (General/ OBC /SC/ST/PC) ________________________________________________________ 7. Address for Correspondence House No. Mohalla/Street City/Town/Village District State Pin Code E-mail: E-mail (Alternate): Phone / Mobile :No.

8. Educational Qualifications (from matriculation onwards) Examination Passed Board/University Year of Passing Subjects Marks Obtained Grade/ Division % of Marks Remarks

9. Details of GATE examination GATE Qualified (Answer in Yes or No): ......... (If yes please provide details as under) GATE Registration No. GATE Score Marks Obtained in GATE All India Rank

10. Application Fee Details: Bank Amount Dated DD No.

11. Undertakings by the Candidates (a) I hereby certify that the foregoing particulars are correct. I understand that my admission may be cancelled and total fee paid by me may be forfeited if the particulars given by me in this application are subsequently found to be wrong. I agree that institutes rules and decisions thereby in all matters concerning my admission, studies, discipline and conduct will be final and binding on me.

(b)

Date: .........../............/2012 (Signature of Applicant) 12. Undertaking by Parents / Guardian I testify that my son / daughter / ward....................................................................... is seeking admission with my consent and I am personally responsible to the University for payment of all his/her dues. I assure that the applicant will abide by the rules of the University. Date: .........../............/2012 (Signature of the Parents / Guardian)

Duly filled in hard copy of the application form with following enclosures (photocopy only) must reach Head, Admission Cell, NIFTEM, Plot No 97, Sector 56, HSIIDC Industrial Estate, Kundli 131028, Distt. Sonepat, Haryana, on or before June 16, 2012 (June 23, 2012 with late fees): 1. Certificate of class X in support of date of birth 2. Marksheet/Certificate of appearing in the qualifying examination
3. GATE Admit card and score card, if applicable 4. DD with due application fee in favour of NIFTEM payable at SBI, Branch - NIFTEM Campus

Kundli (Branch Code 15479)