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Indian Institute of Technology, Bombay: M.Tech. Admissions 2005-2006 Sr. No

The document appears to be an application form for admission to the M.Tech program at the Indian Institute of Technology Bombay for the 2005-2006 academic year. It requests information such as the applicant's name, GATE exam scores, academic qualifications, departments applied to, publications, and demand draft details. The applicant is asked to provide personal details, qualifying degree information, academic records, research interests, and category of assistantship or financing. They must also attach copies of GATE scorecards and experience certificates.

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36 views

Indian Institute of Technology, Bombay: M.Tech. Admissions 2005-2006 Sr. No

The document appears to be an application form for admission to the M.Tech program at the Indian Institute of Technology Bombay for the 2005-2006 academic year. It requests information such as the applicant's name, GATE exam scores, academic qualifications, departments applied to, publications, and demand draft details. The applicant is asked to provide personal details, qualifying degree information, academic records, research interests, and category of assistantship or financing. They must also attach copies of GATE scorecards and experience certificates.

Uploaded by

thulasiramaswamy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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INDIAN INSTITUTE OF TECHNOLOGY, BOMBAY

M.TECH. ADMISSIONS 2005-2006

Sr. No.

1. Name in full: (as in qualifying degree certificate)


Paste (do not pin) passport
size photograph in this
space and get it attested by
Principal/Head of College/
University last attended or
a Gazetted Officer

2. (a) GATE records: (Attach copy of GATE score card)


Reg. No.

Year

GATE Percentile

.s

AIR
(b) Other Competitive (All India) Exams Score, if any
(Like NCST (D Level), AIIMS/ MCI/ GIPMER/ PGI Chandigarh/ AFMCPune)

Name of competitive exam: _____________ Year:


3. (a) Address of the candidate for communication

Score:

.s

_______________________________________

(b) Name & Address of Parent/ Guardian


(i.e. Permanent Address)
_____________________________________

_______________________________________

_____________________________________

_______________________________________

_____________________________________

City ____________________________

City ______________________________

State _____________Pin

State ____________Pin

4. Telephone: (with STD code) ____________________ E-mail: _______________________________


5. Date of Birth:

6. Sex:
D D

8. Marital Status:
9. Qualifying Degree:

M M

7. GN/SC/ST/PD:

Y Y

(Write M for Married/ S for Single)


10. Qualifying Discipline:

12. No. of years of Experience: a) Teaching :

11. Status of Examination:

b) Industry :

(attach experience certificate)

13. Details of Academic Record of Qualifying Examination:


Institute/University

Examination Passed

Year of Passing

Class/Division

Average % of
Marks/ Grade

14. * Departments/Interdisciplinary Groups/Centre and Schools applied for: Candidate can fill in any
three Departments/Interdisciplinary groups/Centre/Schools (in column I) in order of preference (from
the codes listed below at *). Write specialization of your interest (if any) against the Departments you
have applied for in column II (under 1 to 5). For list of specialization refer to brochure.
II Specializations

I
Department/Interdisciplinary groups/
Centre/Schools
(i)

(ii)
(iii)
15. # Categories under which you want to apply: (write in order of preference)

16. Papers published, if any: (Please attach extract)


No. of Papers: Published --

Under publication --

17. Declaration:
I certify that the information given above is correct and I am aware that providing incorrect information in
the application form will result in cancellation of the admission.
Place:

Date:

Signature of the Applicant

* Departments/Interdisciplinary Groups/Centre/Schools

AE
CH
CE
CS
GS
EE
ME
MM

Departments
Aerospace Engineering
Chemical Engineering
Civil Engineering
Computer Sc. & Engg.
Earth Sciences
Electrical Engineering
Mechanical Engineering
Metallurgical Engg. &
Materials Science

Interdisciplinary Groups
CO Corrosion Sc. & Engg.
EN Energy Systems Engg.
IO IE & OR
RE Reliability Engineering
SC Systems & Control Engg.

Centre
EV
IT
BM

Environmental Sc. & Engg.

Schools
School of Information
Technology
School of Biosciences &
Bioengineering
(Biomedical Engg.)

# Categories: TAInstitute Teaching Assistantship, TAPTeaching Assistantship through Project, RA


Institute Research Assistantship, PAProject Research Assistantship, PSProject Staff, ISInstitute Staff,
SFSelf-financed, SWSponsored candidates
Details of Demand Draft
Demand Draft No.: ___________________ Demand Draft Date: _______________________________
Amount: ___________________________ Bankers Name: ____________________________________

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