COER SCHOOL OF MANAGEMENT (COER-SM)

COLLEGE OF ENGINEERING ROORKEE(COER)

Post Box No. 27, 7th Km. Roorkee-Hardwar Road,
VardhmanPuram, Roorkee (U.K.) 247667
Phone No - +91-01332-282500, 279737, 282516

APPLICATION FORM FOR ADMISSION INPOST GRADUATE PROGRAMME - 2014

Form No.-14-

Instructions for filling the Application Form :

1.Please read the attached sheet'INSTRUCTIONS FOR FILLING THE APPLICATION

FORM'

carefully beforefilling each item in the application form. No column should be left blank. Write 'NA'

Paste
Self-Attested
Recent
ColouredPhotograph

if not applicable.
2. Fill the application form in capital letters. The form should be complete in all respects.
3. Incomplete application will not be accepted.
4. Paste your recent photograph in the space provided, do not staple it.

Program Applied for

(Please Tick)

MBA

MCA

MCA(Lateral Entry)

A. Personal Information
Surname
First Name
Middle Name
LAND LINE NO(WITH CODE) :_ _ _ _ _ _ _ _ _ _ _ _ _ _ _Mobile No._ _ _ _ _ _ _ _ _ _ _ _ _
Email : _________________________________

Date of Birth

Fathers / Husbands / Guardians NameSurname

First Name
Middle Name
LAND LINE NO(WITH CODE) :_ _ _ _ _ _ _ _ _ _ _ _ _ _ _Mobile No._ _ _ _ _ _ _ _ _ _ _ _ _
Email : _________________________________

Mothers NameSurname
First Name
Middle Name
LAND LINE NO(WITH CODE) :_ _ _ _ _ _ _ _ _ _ _ _ _ _ _Mobile No._ _ _ _ _ _ _ _ _ _ _ _ _
Email : _________________________________

CategoryGEN

JAIN

Gender

MALE

SC
FEMALE

ST

OBC
Nationality

State from Graduation Examination Passed

Address for Correspondence

House No. /
Area/Street
City
State
Pin Code
Telephone No.
E-Mail ID

NRI*

FN

PH

State of Domicile

Year

AF

B. Academic Qualifications
Educational Qualifications
Examination

Name of Degree /

Board /

Major

Examination

University

Subjects

Year of
Completion

% Marks
Obtained

High School
/Equivalent
(10th)
Intermediate
/ Equivalent
(12th)
*Graduate
Degree /
Equivalent
Post Graduate
Degree
(*Please mention average Percentage of all the years of graduation , if completed. Otherwise write appearing and mention the
average percentage of marks/GPA obtained in all the years of degree course completed till date)

Composite CMAT /MAT/CAT / UKPGEE(UTU)/ UKSEE Score: _______

Hostel/Mess Facility Required

YES

(Attach a Photocopy of the validCard)

NO

Form Issued against CASH Receipt of ` 1000.00 vide receipt no.__________ date ___________ OR by
D.D. No.____________Date_________ of `_________ of Bank___________________________

Declaration by the Applicant I hereby declare that the above entries in the form
are true to the best of my knowledge and belief. I
also declare that no criminal proceedings are/were
against me in any court of law or any other authority
of the country. Further I hereby undertake to abide
by the rules and regulations of the college /
hostel/mess, as may be laid down from time to time.
In case of any wrong declaration my admission may
be cancelled and I will have no objection to the
same.

_______________________________________
Signature of the Parent / Guardian
Name : ..
Place :.Date :.

______________________________________
Signature of the Applicant
Name : ..

For Office Use Only

Recommended / Not Recommended for Counseling
Admitted/Not Admitted

Receipt No.

Date

Chairman(Admission Committee)
Amount

Office Superintendent
Chairman (Admission Committee)

ELIGIBILITY:A.

MBA:Graduation in any discipline with 50% Marks

B.

MCA : Graduation in any discipline with 50% Marks alogwith Mathematics as subject in 10+2 / Graduation

C.

MCALateral Entry : BCA / B.Sc.(IT) / B.Sc.(CS) with 50% marks alogwith Mathematics as subject in
10+2 / Graduation

For admission in MCA /MCALateral Entry UKSEE score card is required.

INSTRUCTIONS FOR FILLING THE APPLICATION FORM -

1.

The spelling of the name of the candidate, his/her father and motherfilled in the Application form should be the
th

th

same as in his/her 10 , 12 and graduation certificates.

2.

Every candidate must indicate category of reservation for which he/she wants to apply, In case, the student do
not write category, he/she will be considered only in general category.

3.

Photocopies of the following documents (duly attested by a gazetted officer) are required to be attached with
the Application Form.
a. Valid CMAT / MAT/CAT / UKPGEE / UKSEE / Any other equivalent exam Score Card
b. Reserved Category Certificate (If Applicable)
c. Domicile Certificate
d. High School Mark sheet (Date of Birth verification)
e. Intermediate Mark sheet
f. Graduation Mark Sheets (All Three Years)

4.

The original copy of the documents mentioned in para 3 to be produced at the time of counseling / admission

5. Eligibility of NRI
a.
NRI seats will be filled by the son/real brother/real sister of such NRI's who have passed intermediate
or equivalent examination with a minimum of 50% marks in graduation.
b.
All such candidates must submit a certificate from Indian Diplomatic Mission/Chancellery/High
Commission under their seal to the effect that the candidate or his father/her father/mother/real
brother/real sister is a NRI in the country
c.
FN/NRI candidates are required to furnish equivalence certificate of qualifying examination from
Association of Indian University (AIU) located at AIU House, 16 KotlaMarg, New Delhi along with the
Application Form.
6. Candidates of physically handicapped category are required to produce the Medical Certificate from the Chief
Medical Officer of the District concerned, which should indicate the extent of disability in support of their claim.
7.The students will be required to submit migration certificate within one month of the commencement of regular
classes.
8.The following is list of various categories
GEN-General, JAIN, OBC-Other Backward Class, SC-Scheduled Caste, ST-Scheduled Tribe
NRI-Non Resident Indian, PH-Physically Handicapped, AF-Armed Forces