Guru Nanak Dev Engineering College, Ludhiana-141006

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GURU NANAK DEV ENGINEERING COLLEGE, LUDHIANA-141006

An Autonomous College u/s 2(f) and 12(B) of UGC Act,1956


Institute Accrediated by NAAC (A Grade) under UGC and TCS
AICTE Approved, Punjab Govt. Aided Status, , Affiliated to Punjab Technical University.Jalandhar
ISO : 9001 : 2008 Certified. UG Programmes accrediated by IEI

Sr. No._________
__________________________________________________________
APPLICATION FORM FOR ADMISSION TO POST GRADUATE COURSE – M.Tech. (Full –Time)2019-20

Name of Course _________________________________________________________________________


Self attested
1. Name in full (Block Letters) Mr./Ms./Mrs.__________________________________________ passport size
Photograph

2. Father’s Name _______________________ Father’s Occupation_________________________

3. Mother’s Name_ ___________________________ Mother’s Occupation________________________________________

4. Date of Birth_________________________________ Place of Birth________________________________________________

5. Sex : [Male / Female] ______________________ Marital Status_______________________________________________

6. Seat Type: (Punjab State 85% or Other State 15%) ____________________________________________________________

7. Category : _________________________Sub Category__________________ Nationality _________________________

8. Blood Group______________________________ Adhaar Card No:______________________________________________

9. Whether GATE qualified (Yes/No)__________, GATE Registration No.__________________________________

10. GATE (Marks out of 100)_____________, GATE Score___________, GATE Stream____________________________

11. GATE All India Rank_______________________, GATE Qualifying year_____________________________________

12. Present Address_________________________________________________________________________________________

_________________________________________________________________________________________________________________

13. Permanent Addresss____________________________________________________________________________________

________________________________________________________________________________________________________________

14. Phone / Mobile No.___________________________________E-mail___________________________________________

15. . DD No.________________ dated__________________ for Rs.1000/-(Rs. One thousand only) Non


refundable, drawn on _____________________ bank (any nationalized bank) in favour of Principal,
Guru Nanak Dev Engineering College, Ludhiana, payable at Ludhiana.
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GURU NANAK DEV ENGINEERING COLLEGE, LUDHIANA-141006
An Autonomous College u/s 2(f) and 12(B) of UGC Act,1956
Institute Accrediated by NAAC (A Grade) under UGC and TCS
AICTE Approved, Punjab Govt. Aided Status, , Affiliated to Punjab Technical University.Jalandhar
ISO : 9001 : 2008 Certified. UG Programmes accrediated by IEI

16. Academic Qualifications (attach proof) :-


Senior Secondary (12th ) /
Examination passed Matriculation (10th) Diploma B.Tech./B.E

Board/ University

School /College

Board /Univ. Roll No.

Year of Passing
Marks Obtained / Total
Marks

% age of Marks

*The institute from where passed is recognized by AICTE. Yes/No _____________.


a) I hereby certify that the entire information furnished by me in this form is true and correct to the best
of my knowledge & I have not suppressed any information in any manner. 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 not have any claim on the seat or
the dues paid to the institute.
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 GNDEC, Ludhiana during the period of my studies & 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 hereby solemnly affirm and confirm that the application form is duly filled and submitted with
requisite fees of Rs. _______/- and in case of any discrepancy, it will stand cancelled.
Date________________
Place________________ (Candidate’s Signature)
NOTE: Duly filled application form with required documents and fee must be submitted by hand/post in the
office of Dean (Academics), PG Block, Guru Nanak Dev Engineering College, Gill Park, Gill Road, Ludhiana-
141006 .
___________________________________________________________________________________________________________________________________________
[FOR OFFICE USE ONLY]
Name of student :______________________________________________________________________

Father’s Name :______________________________________________________________________

Mother’s Name :______________________________________________________________________

Branch Allotted :______________________________________________________________________

Category under which


Branch is allotted :______________________________________________________________________

Category (Punjab State 85%) __________________or (Other State 15%) ______________________

Admitted Provisionally on dated:_______/_______/_________.

(Signature of member) (Signature of member) (Program Coordinator M.Tech.)


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