GOVERNMENT COLLEGE OF ENGINEERING & TECHNOLOGY CHACK BHALWAL JAMMU

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GOVERNMENT COLLEGE OF ENGINEERING & TECHNOLOGY

CHACK BHALWAL, JAMMU.

Application Form for Admission to First Semester of

Four Year B.E.Degree Course

( Session 20___ )

1. Name of the Applicant :............................................................................ (Capital Letters)

2. Father’s/Guardian’s Name :............................................................................

3. Permanent Address :............................................................................

.............................................................................

4. Correspondence Address :............................................................................

.............................................................................

5. Contact No. Mobile:............................ Tel..............................

6. Father’s/Guardian’s Occupation :............................................................................

7. Monthly Income of Father/Guardian :............................................................................

8. District :............................................................................

9. Postal Address for Correspondence :............................................................................

.............................................................................

10. Date of Birth :............................................................................

11. Marital Status (Tick Mark) Married.......................Unmarried.......................

12. Sex (Tick Mark) Male........................... Female.............................

13. Religion :...................................Caste...............................

14. Academic Record (Other than 10+2 Examination)

Name of Examination Institution Board/ Year Division in %age of University Aggregate Marks

15. Roll No. of Entrance Examination :............................................................................

16. Sr.No.of Selection list :............................................................................

17. Merit (Points Obtained) :............................................................................

18. Category against which selected :............................................................................

19. Branch Allotted :............................................................................

20. Academic Record :............................................................................

Passed 12th Class From:.............................................Board Under Roll No:.................

DECLARATION

I hereby declare that the statements made above from Sr.No.(1) to (21) in this application form are true, complete and correct to the best of my knowledge and belief. In the event of any of the particulars or information furnished by me above being found incorrect of or untrue at any stage, the provisional admission granted to me will be liable to be cancelled.

I also undertake that the admission to the College if found eligible is purely provisional at my own risk and responsibility subject to fulfillment of statutory and other requirements of the Institution/University with which the College is affiliated.

Place:.....................

Date :......................

Signature of Parent/Guardian Full Signature of the Candidate

Principal

Documents Attached :

Original documents alongwith two copies of each certificates duly attested must be attached :

i) Subject-wise marks certificate of 10+2 Examination (Qualifying Examination).

ii) Matriculation Diploma/Date of Birth Certificate.

iii) Provisional Qualification Certificate of Higher Secondary 10+2 Diploma Certificate.

iv) Migration Certificate from the Board/University wherefrom the candidate has passed the qualifying Examination wherever applicable.

v) Discharge Certificate from the Head of the Institution last attended.

vi) Character Certificate from the Head of the Institution last attended.

vii) Medical Fitness Certificate.

viii) Category Certificate of Revenue Authority authorised to issue certificates in terms of the SRO as amended from time to time.

ix) State Subject Certificate.

x) Income Certificate (For Govt./Autonomous Organisations) a Certificate from the Head of the Department concerned and for others a certificate from the Tehsildar concerned.

xi) 10 Passport Size Photographs.

xii) An Undertaking as appended at “A” from all candidates on Stamp Papers worth Rs.5/- duly attested by 1st Class Magistrate

xiii) An Undertaking as appended at “B” on Stamp Papers worth Rs.10/- duly attested by 1st Class Magistrate from the candidates who have passed 12th Class Examination other than J&K BOSE and from the candidates who were previously studying/ passed B.A./B.Sc./B.Com/Professional Examination other than Jammu University in addition to Undertaking “A” as shown in column (xii) above.

xiv) Admit Card of CET issued by the BOPEE.

xv) Print out of Online Anti-Ragging Undertaking.

Note : All the candidates are directed to fill online Anti-Ragging Undertaking (Affidavit) from the website www.amanmovement.org

The print-out of the anti-ragging undertaking is must alongwith other documents as per UGC and AICTE at the time of admission.

The documents which have not been enclosed : 1..........................................................................................................................................

2.....................................................................................................................................................

3.....................................................................................................................................................

..............................................................................................................................................

For Office Use

22. The student has been found eligible for Provisional Admission to B.E. First Semester of Four Year Degree Course subject to determination of eligibiliyt and Verification of relevant documents etc.

Incharge Admission Registrar

23. The student be provisionally admitted to B.E. First Semester Class.

Principal

GOVERNMENT COLLEGE OF ENGINEERING & TECHNOLOGY

OLD UNIVERSITY CAMPUS, CANAL ROAD, JAMMU.

II. ACADEMIC SECTION

The candidate is eligible for admission to B.E. 1st Semester of 4 Year B.E. Degree Course. Reason if found ineligible.

S.O. (Academic)

III. ACCOUNTS SECTION

Mr./Miss.............................................................. has deposited an amount of Rs.............../- as College Fee vide College Receipt No.................. dt:.....................

Cashier

IV. Library

Mr./Miss................................................... has been enrolled in the records of the Library for availing of Library Facility after having submitted.........copies of his/ her Photographs for issue of Library Cards.

Librarian

V. SPORTS SECTION

Mr./Miss................................................... has filled-in the required forms alongwith ............ passport size photographs for preparation of his/her Identity Card.

Incharge Sports

VI. The candidate is recommended for Provisional Admission to the 1st Semester of 4 Year B.E.Degree Course during the Session 200......... at Govt. College of Engineering & Technology, Jammu.

Registrar

VII. ADMISSION APPROVED

Incharge Admission Principal

FROM ALL CANDIDATES

Annexure-A

UNDERTAKING

i) I shall abide by the rules and regulations prescribed by the GCET and the University of Jammu as amended from time to time.

ii) My admission is to be regulated as per the statutes prescribed by the University of Jammu during the Session 200.........

iii) My admission to the Govt. College of Engineering & Technology, Jammu is provisional subject to the Verification of my documents by concerned authority; and

iv) The admission under reserved category viz............................................ shall be purely provisional subject to its verification from the concerned Issuing Authority and in case of any discrepancy found therein at any time. I shall be personally liable for legal/disciplinary action and my admission to B.E. Course shall automatically stand cancelled.

Place:.................

Date:.................. Signature of the Student

FROM THOSE CANDIDATES WHO HAVE PASSED 12TH CLASS OTHER THAN J&K BOSE.

Annexure-B

UNDERTAKING

I,........................................................... S/o, D/o............................................. R/o ............................................................................................... do hereby declare that I am seeking provisional admission to B.E. 1ST SEMESTER in Govt. College of Engineering & Technology, Jammu on the clear understanding that my admission in the B.E. 1st Semester is provisional and is subject to confirmation on the issue of a certificate of eligibility by the University under rules. If for any reason whatsoever the University decline to issue the said Certificate, my provisional admission will automatically, stand cancelled.

Place:.................

Date:.................. Signature of the Student

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