sityog insitute of technology application form by qingyunliuliu

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									                                            SITYOG INSITUTE OF TECHNOLOGY
                                 (AN AUTONOMOUS INSTITUTE OF GOVERNMENT OF BIHAR)


                              JASOIYA MORE GROWTH CENTER,AURANGABAD-824101, BIHAR



            Application Form for Admission of Foreign Nationals/ Foreign Students/ Persons of Indian Origin (Except citizens
              of Pakistan and Bangladesh)/ Children of Indian Workers in Gulf Countries for Admission to first year degree
                  courses of Engineering/Technology in sityog institute of technology for the academic year 2011-2012.
Type of Candidate (Select appropriate check box with √) [Excluding Citizens of Pakistan & Bangladesh]
1. Foreign National                    3. Person of Indian Origin (PIO)
2. Foreign Student                     4. Children of Indian Workers in Gulf Countries
Application fee Details in form of DD/PO (Non refundable)
      1. Demand Draft Amount in Rs.
     2. Demand Draft MICR Code
     3. DD/PO Number
     4. DD Date
     5. Bank Name
     6. Branch Name

                                                                    Note: -
                                                                    1. Application form fees by
                                                                    DD/PO of Amount
                                                                    Rs 1,000/- for all
                                                                    candidates.
                                                                    2. DD/PO should be in favor
                                                                    of sityog institute of
                                                                    technology Payable at
                                                                    aurangabad
                                                                    [Drawn on the Indian
                                                                    Nationalized/ Scheduled/
                                                                    Private sector Commercial
                                                                    Banks only]




Personal details of the Applicant:-
1. Name (in full):
(Capital Letters)                                                                            Paste recent
2. Gender: (Male- M / Female- F)                                                             color passport
3. Date of Birth                                                                             size photo
4. Place of Birth:                                                                           graph with
4. Place of Birth:                                                                           signature
Town/City____________State/Province____________
Country___________Pin/Zip_________
5. Nationality : ____________________
Name, Relationship and Address of Parents/Guardian:-
1. Name of Parent/Guardian Mr. /Mrs.
2. Indicate Relationship with applicant
3. Contact Address of Applicant (Abroad and in India)
                                        Abroad                                                    If india(if any)


Detailed Address
for correspondence

City/Province/State/Country
Pin Code/Zip Code

Phone/Mobile No.(Country
Code/Area Code)

Fax No.(Country Code/Area
Code)

Email



HSC/Equivalent Examination Details:-
Name of                 Name of School/      Place of the       Name of Board/      Month &            Medium of
Examination             College              School &           University          Year in            Instruction in
                                             Country                                which              Qualifying
                                                                                    Passed             Exam.




2. Marks in Qualifying Examination (If Marks are in Grades, get equivalent marks from the Authority before
filling)

Sr.           Name of the       Marks          Out of           Sr.                              Marks         Out of
No            Subject           obtained                        No                               Obtained


1             English                                           5     PCM (Physics, Chemistry,
                                                                      Mathematics added
                                                                      together )

2             physics                                           6     Grand Total

3             chemistry                                         7     PCM % of Marks

4             Mathematics                                       8     Aggregate %of marks

Particulars of passport (Copy to be enclosed):-
1. Passport Number                         4. Date of Issue
2. Place of Issue                          5. Valid up to
3. Issuing Authority
Particulars of Student Visa, if already obtained:-
1. Visa Issued by                              4. Visa Number
2. Date of Issue                               5. Valid up to
3. Category/Type of Visa
Choice of course in order of preference:-
For Details please refer the Branch wise distribution of seats as indicated in cut-off list displayed. Put the order of
Preference in the form of Number i.e. 1, 2, 3 etc.


Sr.no.          Course Name                                                      Order of preference
1
2
3
4
5
6
7
8


Declaration by the applicant:
I Mr./Ms.____________________________, hereby declare that all the particulars stated in the application and
enclosures are true to the best of my knowledge and belief. I have read the Guidelines and I shall abide by the terms
and conditions therein. I understand that my admission will be provisional and in the event of my candidature being
found ineligible at a later date, I will be denied admission and, if already admitted, my admission will be stand
cancelled. I also understand that in all matters concerning admission, the decision of the competent authority is final
and I shall abide by it.
I also declare that there is no any criminal case against me, if any information submitted herein is found fraudulent,
incorrect or untrue; I am liable for criminal prosecution.
Date:-

Place:-




Signature of Father/Mother/Guardian*                                                      Signature of Applicant
(* If Father/Mother are not alive)
Enclosures: ATTESTED DOCUMENTS TO BE ATTACHED WITH THIS APPLICATION
FORM.
(A) For Person of Indian Origin (PIO)/ Children of Indian Workers in Gulf Countries
1. Proof of PIO / NRI from the Indian Embassy in the respective country.
2. Residence proof / Work Permit
3. Passport of applicant is mandatory in case of PIO and also in case of Foreign nationals/ Foreign students.
4. In case of PIO passport of applicant and either of his/her Parents or Grand Parents or Great Grand Parents
issued by Government of India is also required.
5. Completed Application form with recent colour photograph pasted and signed in the space provided.
6. Application fee of Rs.1,000/- (Non refundable) in the form of Demand Draft in the name of Sityog Institute of Technology ,payable at
Aurangabad.
7. HSC (10+2) Examination Mark sheet or in case of grade sheet, an equivalent mark sheet showing the relationship
between grades and marks issued by the competent authority.
(B) For Foreign National / Foreign Student
1. Passport of the Applicant
2. Passport of applicant is mandatory in case of Foreign nationals/ Foreign students.
3. Completed Application form with recent color photograph pasted and signed in the space provided.
4. Application fee of Rs. 1,000/- (Non refundable) in the form of Demand Draft in the name of Sityog Institute of Technology ,payable at
Aurangabad.
5. HSC (10+2) Examination Mark sheet or in case of grade sheet, an equivalent mark sheet showing the relationship
between grades and marks issued by the competent authority.

Completed Application form along with the required documents
should be sent to:-
To,
The Chairman,
F. Y. B. Tech. Admission Committee 2011-12
Sityog Institute of technology,Jasoiya More Growth center Aurangabad, Bihar-824101(India)


Email: - info@sityogengg.com
Contact Persons: -
Sr.no.                      Name                             Designation                     Contact no.



01                          Rajesh kr. Singh                        SECRETARY                9322698410

								
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