Download from www.niceindia.

com

1
E$TD : 1787






Email : i. nicenet@giasmd01.vsnl.net.in, Tele. : 04651250966,252966,
ii. nicenet@mailcity.com 250566,250266.
Website : http:/ / www.niceindia.com Fax : 04651 250266, 257266




NOORUL I SLAM COLLEGE OF ENGI NEERI NG
Kumaracoil, P.B.No. 1, Thuckalay, Pin : 629 180
Kanyakumari Dist, Tamilnadu

Approved by the A.I.C.T.E., Govt. of India and Affiliated to Anna University, Chennai
Accredited by National Board of Accreditation, AICTE, New Delhi
An I.S.O 9001:2000 Certified Institution, and Accredited by Institution of Engineers (India)

Application for Admission to the Second Year B.E.
Degree Course


Candi dat es appl yi ng f or admi ssi on must send t he
appl i cat i ons dul y f i l l ed i n t o: -





The Chai rman
Noorul Islam College of Engineering
Kumaracoi l , Thuckal ay P. O.
K. K. Di st , Pi n : 629 180




1. NAME OF THE CANDIDATE ________________________________________

Parents Name and address for ________________________________________
Communication ________________________________________
________________________________________
________________________________________
2. Telephone No. (if available) with Code : Pin Code


3. Place of Birth :
(Tick appropriate column)

4. Sex Male Female
Date Month Year Age as on 01.07.2006
5. Date of Birth (Christian Era)


Day, month and year should be entered only as a two digit number
(Example 3-1-1963 should be entered as 03-01-63)

6. a) Religion : Hindu Muslim Christian Others

b) Community :


7. Mother Tongue :


Affix Latest
Passport Size
Photo Here
Govt. Management
Village Town City
SC ST MBC Backward Forward
I I B.E. - Lateral Entry

Download from www.niceindia.com

2




8. Name of the Parent/ Guardian and Address : .
.
.
.
9. Monthly Income of Parent/ Guardian :

10. Proficiency in Sports & Games :


11. Choice of Branch :

Branch
Code No.




Performance Order
I I I I I I I V V VI VI I


COMPUTER ENGINEERING

ELECTRONICS &
COMMUNICATION ENGINEERING

ELECTRICAL & ELECTRONICS ENGG.

MECHANICAL ENGINEERING

ELECTRONICS & INSTRUMENTATION
ENGINEERING

INFORMATION TECHNOLOGY

AERONAUTICAL ENGINEERING

1


2

3

4


5

6

7














12. Academic Performance : (From IX Standard, X Standard and Polytechnic)

Sl.
No.
Name of the Institution with Address Class Year of Passing
1.
2.
3.
4.
5.

13. Qualifying Examination :

Reg. No. _______________ year of passing _____________Name of Polytechnic


Language Tamil English Other
14. Medium of Instruction
Code No. 1 2 3




Download from www.niceindia.com

3



15. Marks obtained in the qualifying examination

Pre-final Semester (Diploma in Engg.) Final Semester (Diploma in Engg.)
Subjects Marks
Obtained
Maxi.
Marks
Prece-
ntage
Subjects Marks
obtained
Maxi.
Marks
Prece-
ntage
i.

ii.

iii.

iv.

v

vi.
i.

ii.

iii.

iv.

v

vi.

Marks out of 200 : (% of Pre-final Semester + % of Final Semester)

N.B : Name of subjects and relevant portion may be filled up.

16. Certificate of marks in qualifying examination

a. Qualifying Examination;
Name of Polytechnic last studied :

b. Name of Board :

c. Number of appearance (s) :

d. Reg. Number with month and year of appearance (s)

i. First appearance . .. ..
ii. Second appearance .. .. ..
iii. Third appearance .. .. ..
(Reg. No.) Month Year

17. Whether you need Hostel facility : Yes No

Certified that the above entries are the true to the best of my knowledge and belief.




Signature of the Candidate



Station : Signature of Parent/ Guardian

Date :



Download from www.niceindia.com

4
J OI NT DECLARATI ON BY THE PARENT/GUARDI AN AND THE CANDI DATE

I hereby solemnly and sincerely affirm,

1. That the statements made and information
furnished in my sons / daughters / wards application as
also in all the enclosures thereto submitted by him/ her
are true, Should it however be found that any information
furnished therein is untrue in material particulars, I realize
that I am liable to criminal prosecution and I also agree to
the forfeit of the seat in the I nstitution.

2. That my son/ daughter/ ward would conform
strictly to all rules and regulations in force now or which
may be introduced in the I nstitution hereafter and that I
realize that breach of discipline and rules on my
sons/ daughters/ wards part would entail summarily
forfeiture of his/ her seat in the I nstitution.

3. a) That I am aware that if my son/ daughter / ward
does not put in a minimum of 75 percent attendance
during the year/ semester in theory, drawing and practical
classes separately, my son / daughter / ward will not be
eligible to appeal for the University Examination.

b) That I am aware of the rules regarding the
condonation of attendance namely that a student failing
to secure between 65 and 75% attendance can get the
shortage of attendance condoned by filing an application
for condonation to the University alongwith the requisite
condonation fee on Medical grand, on producing Medical
Certificate.

and that the student securing attendance below 75%
in a semester will have to repeat the course work of that
semester in next academic year resulting in the loss of
one academic year for the student.

and that students can avail the facility of condonation
of shortage of attendance only once during the entire
course of study.

4. That I am aware that the curriculum of the various
courses is not rigid and that my son/ daughter/ ward will
follow the syllabi for the various courses in force at the
time of his/ her admission and that any revision or
modification made in the syllabi during the course of his
her study in the I nstitution will be binding on him/ her.

5. That we are aware of the Legislation on prevention of
Ragging and that he/ she will not indulge in any act
amounting to ragging.

6. That I am aware that if my son/ daughter/
ward does not show consistent progress of
marks in the day to day valuation of his/ her
work and progress he/ she will not be sent up for
the University Examination.

7. That in case of my sons daughters/ wards
progress in studies is uniformly poor in the
I nstitution his/ her studies are liable to be
terminated by the issue of Transfer Certificate.

8. That in case of my son/ daughter/ ward
becomes a scholarship holder or comes to enjoy
educational concessions like half-fee, or full fee,
etc, and does not show special progress, the
scholarships or educational concessions are
liable to be cancelled and that if my
sons/ daughters/ wards conduct and character
are not good these will be cancelled

9. That my son/ daughter/ ward is aware that
breach of discipline and rules or bad conduct in
the N.C.C. or extra-curricular activities will also
entail summarily forfeiture of seat in the
I nstitution, in addition to such other proceedings
that may be taken against him/ her.

10. That I am aware that is my son/ daughter/
ward as admitted into the hostel he/ she will
strictly abide by the rules and regulations in
force in the hostel and that any breach of
discipline or rules or any unruly conduct or
undesirable activities will be summarily dealt
with by forfeiture of seat both in the hostel and
in the I nstitution in addition to such other
proceedings that may be taken against him/ her.

11. That I am aware of the rules regarding the
refund to Tuition fee remitted in the College at
the time of admission and that if the student
discontinues his/ her studies after month he/ she
cannot claim any refund of Tuition fees.


Place : Signature of the Candidate


Date : Signature of the Parent/Guardian