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MANONMANIAM SUNDARANAR UNIVERSITY

Centre for Information Technology and Engineering


TIRUNELVELI - 627 012. (INDIA) - YEAR – 200 - 200

Application for admission to - 5 Year Integrated M.Tech. (ICT) - Full-time (B.Tech. + M.Tech.)

I Year Admission / Direct II Year Admission (Lateral Entry)

Subject : (Indicate the subject the candidate proposes to join)

Information and Communication Technology

1. Name of the applicant in full (in Block Letters) (Space for affixing passport
size photograph)
Name in English :
The attesting officer should
Name in Tamil : sign at the bottom with his seal.

2. Sex Male Female


Tick the appropriate box

3. Age and Date of Birth


(Xerox copy of School Leaving Certificate
as proof of age to be attached)

4. Place of Birth, District & State

5. Mother Tongue

6. Religion and Nationality

7. Name of the Community


Attested Xerox copy to be attached OC BC MBC DNC SC/ST
(Tick Appropriate box)

8. Address to which communication is to be sent with pincode.


Phone / Mobile Number with STD code.

Email: Mobile:

Locality Rural / Urban


9. Name, Occupation & Address of Parent / Guardian
(Pincode should be mentioned)

10. Monthly income of Parent / Guardian

11. College previously studied with date of admission &


withdrawal

12.

Marks secured

Total % of
University
Institution

Part wise
Reg. No.

Division
Subject
Board /
Course

Class /

Marks
Sl.No.

i. S.S.LC / H.Sc. /
or equivalent

ii. Degree Level

Part – I

Part – II

Part – III

Major

Ancillary/Allied/EDOC

iii. Any Other qualifications


(Give Details)

Necessary attested copies of the Certificates should be sent along with the application.
13. For the M.Tech. (ICT) 5-year Integrated (B.Tech.+M.Tech.)Course Students – First Year and Direct Second
Year (Lateral Entry) Admissions only:

Details of qualifying examination:______________________________________________________________

Name of Qualifying Exam-HSC/DIPLOMA/B.Sc.DEGREE:_________________________________________

Year of passing:___________________________________ No. of attempts: ___________________________

Affiliating body: ____________________________________________________________________________

The place and institution last studied:____________________________________________________________

Kindly fill in mark as applicable:

SUBJECT MARKS OBTAINED % OF MARKS

Marks Obtained in course subject (for HSC Academic):

MARKS % OF
SUBJECT OUT OF
OBTAINED MARKS
A. Mathematics
B. (Physics & Chemistry (put together)) or
(Physics & Chemistry (put together) and Computer Science)
Total % (A+B)

Marks Obtained in course subject (for 3-year DIPLOMA and B.Sc. ) :

Name of No. of Year of Total Marks in optional Subjects


Examination University attempts Passing Marks
/Board to pass secured
the Exam _____% Max.marks Marks Sec.

a) Diploma (3 years) _____ % in final year

b) B.Sc. with
Mathematics as a paper. _____ % in
(3 years) (part III and Ancillary Maths)

Necessary attested copies of the Certificates should be sent along with the application.
14. Was the candidate a holder of any Scholarship
(Millitary or any other Govt)? / Rank in sports /
Physically Handicapped, if any Give details.

15. (a) Details of application made for admission to


College / University Departments and also for other
courses including professional courses this year

(b) Details of any other courses studying now (if any)

I declare that the particulars given above are correct, and that I will, if admitted, abide by the rules of the University.

Signature of the Candidate

Place :

Date :

Particulars given above are correct. I declare that the candidate will abide by the rules of the University.

Counter Signature of the Parent / Guardian

Place :

Date :
CHECK LIST FOR THE CONVENIENCE OF CANDIDATES

List of Enclosures:

1. Application fee: D.D. No.: Amount : Rs.

2. GATE /TANCET score card copy (Optional Only) GATE / TANCET Roll No:

3. (Affixed) Photographs:

4. Xerox copy of X/XII/Degree/Provisional certificate/Mark sheets/Degree Certificate

5. Xerox copy of SC/ST and PH Certificates

6. Community Certificate

7. Others (if any)

FEES REMITTANCE SLIP - FOR OFFICE ONLY

Application No / Reg. No. :

Name of the Candidate:____________________________________ Course:______________________________

Date of registration:____________________________ Amount Payable:_________________________________

DATE MODE OF PAYMENT AMOUNT PAID

CHIEF ACCOUNTANT
Address Slip

Candidates are requested to fill in the following address slips and send them along with the application

1. Appn. No. 2. Appn. No.


Name and address : Name and address :

Pin code : Pin code :


Phone / Mobile : No.: Phone / Mobile : No.:

3. Appn. No. 4. Appn. No.


Name and address : Name and address :

Pin code : Pin code :


Phone / Mobile : No.: Phone / Mobile : No.:

Print and mail the filled application along with the DD towards the cost of application for Rs. 300/- (for

SC/SC free of cost) and Rs. 150/- for Entrance Examination drawn in favour of The Registrar, Manonmaniam

Sundaranar University payable at Tirunelveli.

may be mailed to

Dr. N. KRISHNAN
PROFESSOR AND HEAD
CENTRE FOR INFORMATION TECHNOLOGY AND ENGINEERING
MANONMANIAM SUNDARANAR UNIVERSITY
TIRUNELVELI – 627 012, TN