ANNA UNIVERSITY OF TECHNOLOGY MADURAI Alagar Koil Road, Madurai

Transcription

1 Application No.: (Office use only) ANNA UNIVERSITY OF TECHNOLOGY MADURAI Alagar Koil Road, Madurai Details of the Demand Draft Application for Provisional Eligibility Certificate (For candidates seeking admission in affiliated Engineering Colleges under Foreign National / PIO (Person of Indian Origin) Category Link No.: Affix recent passport size photo (Attested by the Principal with name seal) Demand Draft No. Date Amount Name of the issuing bank Rs.2000/- For Admission to UG PG Programme 1. Name and address of the College affiliated to Anna University of Technology Madurai to which admission is sought: 2. Name of the Degree & Branch to which admission is sought: 3. If UG, specify the year of admission I Year Lateral Entry 4. Date of Provisional admission in the College: 5. Name of the Candidate as per the school certificate (In CAPITAL LETTERS) 6. Name of the Parent (with Initials) (Father) (Mother) 7. Candidate s Address for Correspondence : Phone : Mobile :

2 8. Gender : Male / Female 9.Date of Birth : 10. Name of the qualifying examination passed : Day Month Year 11. Name of the Board/ University : 12. Pattern of Education (Under which the examination passed) For UG For PG Details of Qualifying Examination: Name of the Examination Register No. Name of the Board / University and Country Year of Passing Medium of Instruction 14. Details of Marks obtained in the qualifying examination. (Attach authenticated transcripts of grades / marks secured in the qualifying examination.) Sl.No Subject Maximum Marks Minimum prescribed marks for passing Marks/Grade obtained in the exam Total Overall Percentage 15. Documents to be enclosed (a) Copies of Academic certificates (i) Attested Mark Sheets of qualifying examination (ii) Attested Provisional / Degree / Diploma Certificate (In case of Degree / Diploma passed candidates only) (iii) Transfer Certificate (iv) Migration Certificate (b) Whether Equivalence Certificate obtained from Directorate of Technical Education / Indian Embassy Concerned: Yes / No. (c) Passport details of the candidate Nationality Passport No. Place of issue Date of expiry

3 (d) Visa Details of the candidate Nationality Visa No. Place of issue Date of expiry (e) In the case of PIO (Person of Indian Origin) Nationality PIO card No. Place of issue (f) In the case of Nepal and Bhutan candidates, Copy of Citizenship Card should be enclosed Nationality Citizenship card No. (g) In case of Refugees from other countries, Copy of Refugee Card / Latest NOC from the Police Administration / Latest Certificate from Tahsildar must be enclosed. Name of the Country Issuing Authority Date of Issue 16. Foreign Residential and Official address for correspondence Res: Office : (if any) Phone: Name & Address of Local Guardian, if any Phone (Off) : Phone (Res) : Fax (Off) : Fax (Res) : Mobile : 18. Full address of the Country s Embassy office in India Phone : Fax (Off) :

4 19. Declaration The particulars furnished in the application are true and correct. In case, any particulars furnished in the application are found to be incorrect at a later stage, I agree to forfeit my admission, no matter, at whatever stage of the course at that time. Place : Date : Signature of the Candidate Certified that 1. The data given above are verified with originals and found correct. 2. The course for which admission is sought for is approved by the AICTE and affiliation is accorded by Anna University of Technology Madurai, Madurai The candidate is admitted to the respective course within the permissible intake under the category concerned as prescribed by the Government. College Seal Countersigned by the Principal with Name Seal.

5 FOR OFFICE USE ONLY 20. CHECK LIST (Tick the relevant boxes) : 1. Valid Passport 2. Valid Visa / PIO Card 3. Citizenship Card for Nepal and Bhutan Candidates 4. Refugee Card / NOC from Police Administration / Certificate from Tahsildar (if applicable) 5. Equivalence Certificate obtained from the Directorate of Technical Education / Indian Embassy Concerned 6. Mark Sheets of the qualifying exam 7. Transfer Certificate / Migration certificate 8. Diploma / Provisional / Degree certificate Whether the application is complete in all aspects: Yes / No Remarks (If any) : Name of the Scrutinizing Officer: Signature with Date Issue of Provisional Eligibility Certificate PEC No. : Date: Received the PEC on: Signature of the Candidate / Representative Signature of the Issuing officer with Date

6 INSTRUCTIONS TO THE FOREIGN NATIONAL / PIO CANDIDATES NOTE: Attested Photocopy of the following documents should be enclosed along with the application and the related Original documents should be produced for verification while submitting the documents. 1. Proof for the Citizenship of the candidate. 2. Passport of the candidate / Citizenship card in case of Nepal and Bhutan candidates. 3. Qualifying Mark list of the candidate (if the grades are produced, Certificates showing equivalent marks to grades should be submitted). 4. Certificate showing that the candidate has undergone the respective course in English medium. 5. Valid Visa / PIO card / Copy of Refugee Card / Latest NOC from the Police Administration / Latest Certificate from Tahsildar. CONDITIONS 1) The Provisional Eligibility Certificate does not guarantee the approval of admission to the Course(s) concerned. 2) The Provisional Eligibility Certificate issued is valid only for the academic year concerned. 3) A demand draft for Rs.2000/- (Rupees Two thousand only) should be drawn in the favour of The Director(Admissions) Anna University of Technology Madurai and is payable at Madurai. 4) Candidates of Person of Indian Origin (PIO) should obtain necessary records from competent authorities of the Government of India. 5) The Candidates are directed to submit the applications duly signed by the Principal to The Director (Student Affairs) Anna University of Technology Madurai, Madurai in person on or before Note: The Link number in the Acknowledgement Card should be quoted in all future correspondences to the University for the issue of PEC