APPLICATION FORM NO:

PEC UNIVERSITY OF TECHNOLOGY, CHANDIGARH

APPLICATION FORM$ FOR ADMISSION TO ME DEGREE COURSE
(For filling this application form see instructions overleaf)

Paste your
To be filled in by the office
Photograph
Diary No. Date: Signature: Here

1. Full Name :
2. Date of Birth : 3. Place of Birth: 4. Sex: Male/Female
5. Marital Status: 6. Nationality:
7. Father’s Name :
8. Address for Correspondence: Codes for Items 11-15 are given overleaf

11. Programme

12. Category
State: Pin Code :
9. If available, please provide: 13. Student Status

Phone No. : Fax No. : 14. Sponsorship Status

E-mail address:
15. Physically Handicapped
10. Details of Demand Draft(for photocopied/ website downloaded form)
a) Amount Rs. …………… No. …………….. dt. ……..……
b) Bank & Branch issued …………….…………………….…………….……….…………………………………
16. Academic Record/Work Experience
A. GATE exam details (*)
Exam Name Exam discipline Score Exam Year

B. Qualifying Degree (*) already obtained or in progress£

University/Institute Discipline Degree Exam Date Final results Min. Pass Marks %
expected by or Grade Average

% Marks or Sem. I Sem. II Sem. III Sem. IV

Grade Point Average Overall % or
Grade Average
Sem. V Sem. VI Sem. VII Sem. VIII (if degree completed)

C. Other Degrees (*) obtained after 10+2 (Do not include the degree listed in 16 B)
University/Institute Discipline Degree Marks Date of completion

D. Working Experience (**)

Dates (from-to) Name & Address of Position Nature of Work
Employer

($) Copies downloaded from the PEC University of Technology website (http://www.pec.ac.in) are acceptable. The downloaded
application forms are to be accompanied by a fee of Rs.400/- (Rs.200/- for SC/ST/Physically handicapped candidates) in the form of a
draft. In case a student is applying to more than one programme, photocopied forms can be used. In that case each additional form
must be accompanied by a fee of Rs.100/-. All forms submitted by the candidate must be received under the same cover. The total fee
may be paid through a single draft.
(*) Attach attested copies of certificates, mark sheets etc. See checklist overleaf for certificates required.
(**) A candidate presently working (including those on projects) must provide a “No Objection/Relieving Certificate” from the employer.
(£) In case the result is given in grade points an authenticated copy of formula for conversion to % marks should be attached.
17. Declaration by the applicant:

(a) I hereby certify that the entries made by me in this form are correct to the best of my knowledge & I have not
suppressed any information in any manner.
(b) I agree to observe & abide by all the rules & regulations of the institute & the hostel that may be laid down from time to
time by the PEC University of Technology, Chandigarh during the period of my studies & training & not to associate
myself with any activity prejudicial to the discipline of the institution.
(c) I fully understand that for any violation or infringement of these rules & regulations, disciplinary action can be taken
against me by the authorities.
(d) I hereby solemnly affirm & declare that I have never been disqualified by any Board/University or convicted on any
account.
(e) I understand that if at any stage it is found that I have provided any wrong information or have suppressed any
information to seek admission to this institute, my admission shall automatically stand cancelled and I will have no
claim on the seat or the dues paid to the institute.

Date: ________ Signature: __________________________

INSTRUCTIONS FOR FILLING THIS FORM

1. Either TYPE or PRINT the entries on the form neatly.
2. Go through the codes for Items 11-15 given below, and fill them carefully in the boxes on Page 1.
3. All items marked with an asterisk (*) require you to submit an attested copy of a supporting document. PLEASE DO NOT SEND
ORIGINALS. Documents for which attested copies are required are given in the checklist. Please tick off the items in the
checklist you are attaching to this form.
4. The application fee of Rs. 250/- must be paid through demand draft in favour of The Director PEC University of
Technology, Chandigarh payable at Chandigarh. The demand draft is not required in case the applicant has purchased the
form from the institute.

CODES (FOR ITEMS 11-15)

Item 11: Programme Codes: {Highways Engg.=HIG}, {Irrigation & Hydraulics Engg.=IRR},{Structural Engg.=STR},{Environmental Engg.=ENV},
{Electrical Engg. = ELE},{Mechanical Engg. = MEC},{Electronics=ECT},{Electronic Product Design & Technology=EPD}, {Industrial
Materials & Metallurgical Engg. = IMM}, {Production & Industrial Engg. = PRO}, {Computer Science & Engg.. = CSE }, {Computer Science
& Engg.(Information Security). = CSE(IS) }
Item 12: Category
SC* : Scheduled Caste (certificate required); ST* : Scheduled Tribe (certificate required); GN : General;
Item 13: Student Status : Full Time : FT; Part-Time : PT
Item 14: Sponsorship Status : Sponsored (*) : SD; Non-Sponsored: NS
Item 15: Physically Handicapped : PH (Physically handicapped certificate – Clearly mentioning % of disability)

Format of Sponsorship Certificate(form I) is attached.

CHECKLIST (CIRCLE THE ENCLOSED DOCUMENTS). SEND ONLY ATTESTED COPIES (NOT ORIGINALS).
1. Date of birth (DOB) certificate or High School (Class Ten) Certificate with DOB (Required for all candidates)
2. SC/ST Certificate if applicable (Item 12)
3. Certificate of Physical Handicap (Type of disability to be attached).
4. Sponsorship Certificate for sponsored candidates (Item 14) Form I
5. GATE score card (Item 16 A)
6. Copies of mark/grade sheets (Items 16 B & 16C)
7. No Objection/Relieving Certificate from employer (for employed candidates)
8. Migration Certificate from the institute attended last
9. Undertaking from the institution attended for the non-declaration of result of the last semester / having appeared in last semester
as per format given in this application form.
10. The Demand Draft for application fees

The completed Application Form must reach

The Officer-in-Charge PG Admissions
PEC University of Technology
Chandigarh-160012
(Name of Parent Department should be superscribed on the envelope)
 Annexure-A

FORMAT FOR CERTIFICATE OF SPONSORSHIP FOR NOMINEES

Certified that ______________________________________________________ son/daughter of

Shri_____________________________________ has been working as_____________________________

(Engineer/Teacher) on regular whole time basis in_______________________________

(Department/Organization) since____________________(date). His/her name is hereby sponsored for

admission to M.E. Degree Programme in* _______________________________________ Engineering at

PEC University of Technology, Chandigarh for the session______________________. In case he/she is

selected for admission, he/she will be relieved of his/her duty and allowed to join the classes for full

duration of the said programme. If he/she leaves this Department/Organization during his/her period of

study, PEC University of Technology will be informed accordingly to cancel his/her admission. Further

certified that he/she shall continue to be an employee of this Department/Organization and shall join back

his/her duties after completing the programme. Certified that this institute is approved by AICTE (only for

an educational Institute).

Date:_____________________ _____________________________________
(Signature & Seal of the employer)
* Both the branch and the department should be mentioned.
 Annexure-B

CERTIFICATE FOR APPEARING IN THE FINAL SEMESTER/YEAR EXAMINATION

(Required from candidates who are yet to appear in the qualifying examination)

I hereby certify in connection with the application of Mr./Ms. ___________________________________

that he/she is a bonafide student of our institution and is applying for admission to PG programme(s) at

PEC University of Technology, Chandigarh. He / She is yet to complete the requirements of qualifying

examination including theory, practical and project examination for B.E./B.Tech./M.Sc./MCA

_____________________ (Strike out the non-applicable ones and write in the blank space if the degree is

not mentioned) and the result is likely to be announced by ______________ 2010. The percentage of

aggregate marks/CGPA obtained by him/her upto pre-final semester / year examination (Strike out the non-

applicable) is __________________. His/her conduct and character during his/her stay at the Institute /

University is “GOOD”.

Place: _________________ Signature of the Principal/Dean/Registrar/

Date: _________________ Dy. Registrar/Proctor/Administrative Officer/
Asstt. Registrar of the institute attending/last
attended with seal
 Annexure-C

CERTIFICATE FOR NON-DECLARATION OF RESULT

(Required during registration from candidates whose result of the qualifying examination has not
been declared)

I hereby certify that Mr./Ms. _________________________________________ has appeared in the final

year examination including theory, practical and project examination for

B.E./B.Tech./M.Sc./MCA________________degree (strike out the non-applicable ones and write in the

blank space if the degree is not mentioned) and the result is likely to be announced by _______________

2010. The percentage of aggregate marks/CGPA obtained by him/her in the pre-final year/semester

examination is __________________ . His/her conduct and character during his/her stay at the

Institute/University/College was “GOOD”.

Place: _____________ Signature of the Principal/Dean/Registrar/

Date: _____________ Dy. Registrar/Proctor/Administrative Officer/
Asstt. Registrar of the institute last attended
with seal
 SCRUTINY FORM FOR ADMISSION TO M.E. COURSES 2010 – 2011
(A separate copy of scrutiny form is to be filled for each application submitted by the candidate)
Diary / Application No._______________
(to be filled by the office)
PART – A (to be filled by the candidate and to be checked by the scrutiny officers)
1. Name___________________________________________________________________________________

2. M.E. Programme applied for;

(a) ____________________________________________________
(b) ____________________________________________________
(c) ____________________________________________________
(d) ____________________________________________________

3. Category: _________________________________Gen (GN) /SC / ST / Sponsored (SD) / Handicapped (PH)/PT

4. Name of the qualifying examination passed (BE / B.Tech/MCA/AMIE / IETE etc.), branch of engineering/science, and
the university_________________________________________________________________________________

5. Marks secured
B.E./ B. Tech./MCA AMIE / IETE Graduates
Secured marks/Max. marks Section Secured / Max. marks

______________/___________marks Section A

Section B

Aggregate of
Sections A and B:

Percentage:

6. Whether qualified in GATE? If yes, % score & Year_______________________________

CERTIFICATES ATTACHED WITH THE APPLICATION FORM

(No separate certificates are to be attached with the scrutiny form)

1 Date of birth (DOB) certificate or High School (Class Ten) Certificate with DOB
2 SC/ST Certificate
3 Certificate of Physical Status (Type of disability to be attached)
4 Sponsorship certificate for sponsored candidates
5 GATE score card
6 Copies of mark/grade sheets
7 No Objection/relieving Certificate from employer (for employed candidates)
8 Migration certificate from the institute attended last
9 Undertaking from the institution attended for the non-declaration of result of the last semester / having appeared in last semester as per
format given in this application form.

Note: Circle the enclosed documents.

………………………………………….

Signature of the candidate

PART - B (To be filled by the Scrutiny Officers)

7. Is the degree from an AICTE approved college/ university or recognized by UGC. YES / NO

8. GATE qualified: YES / NO

9. GATE Score:
B.E./B.Tech./MCA Score:

For AMIE / IETE candidates: (i) Whether passed Diploma before AMIE / IETE: YES / NO

(ii) Whether possesses 5 years experience: YES / NO

10. For Sponsored/Part-time candidates:

Whether possesses requisite 2 years experience in the sponsoring organization: YES / NO

11. If physically handicapped, whether medical certificate attached YES / NO

12. Whether ELIGIBLE / INELIGIBLE:

13. Reasons if ineligible:__________________________________________________________

14. Deficient Documents, if any: ___________________________________________________

____________________________________________________

15. Any other remark: ___________________________________________________________

____________________________________________________________

______________ ________________

Scrutiny officer (I) Scrutiny officer (II)

 PEC UNIVERSITY OF TECHNOLOGY, CHANDIGARH

No. PEC/Stds-5/P.G. Admn./___________ Dated:

1. Your application for admission to the M.E. Degree Programme at this institute has been received

and entered at Sr. No.____________________ in the Register.

2. For all further correspondence with this office, you should quote the Sr. No. mentioned above with

the following particulars.

i. Branch / Specialization
ii. Category against which applied for

For Officer-in-Charge PG Admissions,

PEC University of Technology,
Chandigarh.
 [Write Your Address here legibly]

Affix
Postage
Stamp

To
____________________________________________________

_____________________________________________________

_____________________________________________________