AMRITA MT

Application No.

VISHWA VIDYAPEETHAM
University
(Estd. under section 3 of the UGC Act 1956)
AMRITA CENTRE FOR NANOSCIENCES & MOLECULAR MEDICINE
AIMS Ponnekkara (P.O.), Kochi – 682 041, Kerala, India.

APPLICATION FOR ADMISSION TO MASTER OF TECHNOLOGY (M.Tech.) COURSE - 2011

MOLECULAR MEDICINE
(All entries to be made in BLOCK LETTERS – enclose only copies of certificates)

1. Name of the candidate in CAPITAL letters as given in SSLC or equivalent certificate (leave blank space
between name and initials)

Gender: (Male/Female) Blood Group:

Date of Birth: (DD/MM/YYYY) Native Place: Affix recent

Passport size
Native District : State : Colour
Photograph
Mother Tongue : Nationality :

Religion : Caste :

*Community: Marital Status:

(SC,ST,MBC,BC,OBC,OC)
*(If the certificate is in vernacular, an English version of the same duly attested by a Notary Public should be attached)

2. Academic Record
Branch of study:

Semester Marks/GPA in MSc./B.Tech./BPharm/MBBS/BDS or applicable Masters Disciplines in Life Sciences

Semester/Year# I II III IV V VI VII VIII
Scored
Maximum
Percentage

Total Marks (or Cumulative GPA) of I to VIII Sem.: Maximum

# - If annual pattern is followed, use only first four columns above to enter the total marks in each year.
If semester pattern is followed with a marks-based system, enter total semester marks in appropriate columns.
If semester pattern is followed with a credit-based system, enter each semester’s GPA in appropriate columns.

All the details in the application should be filled. Incomplete application is liable for rejection.

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 3. Class obtained :
University : College:

4. GATE percentile (if applicable): Year:

5. Subjects passed in more than one attempt: (Attach additional sheets if required)
S.No. Title of the subject No. of Attempts S.No. Title of the subject No. of Attempts

6. Professional Experience.
Period
S.No. Designation Nature of work Organization
From To

7. Name of sponsoring organization, if applicable:

(A sponsorship certificate is to be submitted in the format enclosed)

8. (a) Address for communication:

P.O. Taluk:

District: State: PIN Code:

Phone No. with STD Code e-mail:

Mobile:

8. (b) permanent address:

P.O. Taluk:

District: State: PIN Code:

Phone No. with STD Code e-mail:

9. Father’s name :

Age : Date of Birth :

Occupation : Annual income: Rs

Office Address:

P.O. : Taluk:

District: State: PIN Code:

Phone No. with STD Code e-mail:

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 10. Mother’s name:

Date of Birth: Age:

Occupation: Annual income: Rs

(Please specify)

Office Address:
(if applicable)

P.O. Taluk:

District: State: PIN Code:

Phone No. with STD Code e-mail:

11. Name and address of local guardian:

(if applicable)

Phone No. with STD Code e-mail:

Relationship with the student:

12. How did you come to know about AMRITA?

13. Why are you choosing AMRITA for higher studies?

14. List of documents to be enclosed

(Please do not send originals. Send only the attested copies. Please tick off the items in the following list you
are attaching to this form.)

1. SSLC or Equivalent Certificate 6. Transfer Certificate and Conduct Certificate from

2. Plus two the Institute last attended.
3. Degree/Provisional Certificate 7. Community Certificate for all other than OC
4. Mark Sheet for all the Semester/Years 8. The Hall ticket for Entrance Exam duly filled
5. GATE Score card 9. Sponsorship Certificate duly filled.

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15. DECLARATION

I, Son / Daughter of hereby declare that the

particulars given by me in the application are true. I shall produce the original certificates at the time of admission or
on demand. If, in future, any information is found to have been furnished falsely or incorrectly or any information
suppressed to secure admission, I shall withdraw from the programme without any claim or consideration. I further
state that I have read and understood the contents of the instructions before filling the application.

Place: Signature of the Applicant:

Date: Name:

16. DECLARATION BY PARENT/GUARDIAN

I, undertake the responsibility of my son / daughter / ward

________________________________________ who is seeking admission in the Amrita Vishwa Vidyapeetham and
declare that the information furnished by him/her is correct and true and that if in future, any information is found to
have been furnished falsely or incorrectly or any information suppressed to secure admission, I shall withdraw my
son/daughter/ward from the programme without any claim or consideration of the period of study/stage of the
programme he/she has completed. I further state that I have ensured that the candidate has read and understood the
contents of instructions before filling the same.

Place: Signature of the Parent/Guardian

Date: Name:

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 SPONSORSHIP CERTIFICATE
(To be issued by the Head of the Institution)

This is to certify that

has been working as in the Department of

of this Institution/Organization since

. He/She is sponsored for M.Tech in Molecular Medicine degree course (full

time) at Amrita Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham,

Kochi, Kerala.

It is certified that he/she will not be withdrawn from the programme in the middle of the studies.

Date: Signature

Place: Name:

Designation:

Head of
Institution seal

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 AMRITA VISHWA VIDYAPEETHAM Application No.
University
Amrita Centre for Nanosciences & Molecular Medicine
HALL TICKET FOR M.TECH.MOLECULAR MEDICINE
MT
ENTRANCE EXAMINATION – 2011

Name :
Address :

City : PIN : Affix

District : State : Passport size
colour photo
Phone No. : (STD Code)
rd
Exam Centre : 3 Floor, Annex (B-Block), Amrita Institute of Medical Sciences,
AIMS Ponnekkara P.O, Kochi - 682041
Date: 24-04-2011 (Sunday)
Time : 9.30 A.M. to 11.30 A.M.

Signature of
Coordinator-PG admissions

Signature verified

Signature of the Candidate Signature of the Candidate

(to be signed while applying) (to be signed in the exam hall) Signature of the invigilator
Note: Candidates are required to be present in the Exam Hall, at least 15 Minutes before commencement of the exam.


AMRITA VISHWA VIDYAPEETHAM - Amrita Centre for Nanosciences & Molecular Medicine
HALL TICKET FOR M.TECH. MOLECULAR MEDICINE ENTRANCE EXAMINATION – 2011

Application No. MT
(office copy)
--------------------------------------------------------------------------------------------------------------------------------------------------------

Name :
Address :

City : PIN : Affix

Passport size
District : State : colour photo
Phone No. : (STD Code)
rd
Exam Centre : 3 Floor, Annex (B-Block), Amrita Institute of Medical Sciences,
AIMS Ponnekkara P.O, Kochi - 682041
Date: 24-04-2011 (Sunday)
Time : 9.30 A.M. to 11.30 A.M.

Signature of the Candidate Coordinator-PG admissions

(To be signed while applying)

(Note: Both the portions of the Hall ticket are to be submitted by the candidate along with the application)

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 INSTRUCTIONS TO CANDIDATES – M.Tech 2011
The candidates are required to read the
following instructions clearly before filling the application
1. Mere submission of the application does not guarantee admission to the candidate.

2. Fees once paid will not be refunded in case the candidate withdraws on his/her own or on cancellation of
admission due to furnishing false information/ on not joining the University on the specified date/committing
malpractices and consequent disciplinary action.

3. Admission will stand cancelled automatically if the candidate fails to join the University on the specified date.

4. All the relevant original Certificates/mark statements should be submitted at the time of interview or on the
stipulated date.

5. The applicants are advised in their own interest to see the website www.amrita.edu.

6. A self addressed post card (stamped) may be sent along with the completed application form for acknowledging
receipt.

7. The address slips enclosed may please be returned duly filled in CAPITAL LETTERS.

8. The candidate shall submit the application at the following address :

The Director,
Amrita Centre for Nanosciences & Molecular Medicine,
M. Tech Admissions – Molecular Medicine
Amrita Institute of Medical Sciences Campus
Amrita Vishwa Vidyapeetham
AIMS-Ponnekkara P.O, Kochi - 682041, Kerala
Phone : 0484 – 2851832 / 09048062499
Fax: 0484- 280 2030
E-mail : researchsecretary@aims.amrita.edu

*Candidates with valid GATE score are exempted from entrance test.

Last date for receiving completed application : 18-04-2011

Date of Entrance Examination : 24-04-2011

Date of Interview (if selected from entrance exam) : 25-04-2011

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 Syllabus for Entrance Examination for M.Tech Molecular Medicine
Programme – 2011

Questions in all the parts below will be at the Bachelor’s level.

Part – A :Mathematics
Basic Calculus - Algebra – Geometry - Biostatistics

Part – B : Physics and Biophysics

Basic mechanics and laws of motion, electrical and magnetic properties

Part – C : Chemistry
Periodic table, elementary bonding theory, basic inorganic and organic chemistry,
techniques in instrumental analysis

Part – D : Life Sciences

Anatomy, physiology, cell biology, molecular biology, microbiology, industrial
biotechnology, biochemistry, genetics, pharmacology, genetic engineering,
bioinformatics, recombinant DNA technology, virology, immunology.

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 PLEASE FILL UP YOUR COMMUNICATION ADDRESS IN CAPITAL LETTERS
AND RETURN IT ALONG WITH COMPLETED APPLICATION
Name :_______________________________
S/o./D/o:_______________________________
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Application No. MT
Name :______________________________
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Name :______________________________
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Name :______________________________
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