pg application form - … · 8 migration certificate ... authorities of msrit/university, ... are...

Page No. 1(Autonomous Institute, affiliated to Visvesvaraya Technological University, Belgaum)

VIDYA SOUDHA(Recognized by Govt. of Karnataka, AICTE, accredited by NBA)

Subject to Bangalore Jurisdiction Only

M.S.RAMAIAH NAGAR, M.S.R.I.T.POST, BANGALORE -560 054Phone Nos : 080-23600822,23606934,23606936,23607902 WebSite : www.msrit.edu Email : [email protected]

Full Name of Applicant in Block Letters (As per PUC Marks card):

'A' ADMISSION FORM

Phone No. (with Code)

Permanent Address

"Outcome Based Education " software by contineo.in

RAMAIAH INSTITUTE OF TECHNOLOGY

Temp. USN

Branch FOR M.B.A FOR THE YEAR

KEA/PGCET Reg. No. Rank

Quota Category Claimed Category Allotted

First Name Middle Name Last Name/Surname/Initials

Date of Birth Gender Blood Group

Admission Order No. and date

College Code Admission Type

Semester Term

Admission based on CET Fees Paid

Religion Caste Sub-Caste

Current Address

City State Pincode Country


Mobile No. Phone No. (with Code) Emergency Contact Number

Email ID Domicile Area

Place of Birth State of Birth

Country of Birth Birth place Pincode

Nationality NRI Mother Tongue

Disability / Handicap Type of disability Economically Backward

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'B' ACADEMIC DETAILS

B.S.C details

Subject Name Maximum Marks Minimum Marks Obtained Marks

'C' PARENTS DETAILS

Father Details

Address



Total Marks

School/College Town

School/College Country

School/College Name

Board Name

Year of Passing School/College State

Marks Card No. Medium of Instruction

Examination Roll/Reg. No.

Total MAX Marks Class Obtained

First Semester 700 315Second Semester 700 315Third Semester 700 315Fourth Semester 700 315Fifth Semester 700 315Sixth Semester 700 315Seventh Semester 700 315Eighth Semester 700 315Ninth Semester 700 315Tenth Semester 700 315Total 7000 3150Aggregate

Name of Father

If claiming under OBC/GOVT SNQ as per annual income certificate Yes Annual Income

Occupation PAN Number


Mobile No 1. Mobile No 2. Phone No.(with Code)

Email ID

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Mother Details

Address

Sl.No. Documents Original Copies

1 Stamp size photos YES YES

2 10th Marks Sheet YES YES

3 12th Std. Marks Sheet/s. YES YES

4 Admission Order PGCET/KMAT 1 plus 3 YES YES

5 Caster Certificate and Income Certificate (If claiming under SC/ST/1/2A/2B/3A/3B category) YES YES

6 Degree Marks Sheet YES YES

7 Diploma Marks Sheet YES YES

8 Migration Certificate(if studied other than PUC of Kar.) YES YES

9 PDC or Degree Certificate YES YES

10 QUALIFYING EXAM MARK SHEET YES YES

11 Study Certificate 7/10 Years YES YES

12 Transfer Certificate / College Leaving Certificate YES YES



Name of Mother

Annual Income Occupation PAN Number


Mobile No. Mobile No 2. Phone No.(with Code)

Email ID

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OFFICE USE

Admn.Sec.Verified by

A/C.Sec Verified by............................................................to SIS dt.........................................................................................

Dated.................................................................................Fee paid Rs....................................................................................

In charge Accounts Section

Admitted to.........................................................Year/Sem..................................................................................................

PRINCIPAL



Place :

DECLARATION BY THE PARENT / GUARDIAN

1. If there is any false information/fake certificate or any forgery in the Particulars/certificates/documents submitted by my ward to the

authorities of MSRIT/University, my ward's admission may at once be cancelled and necessary action may be taken

2. I agree to the applicant's admission to the Institution. I shall be responsible for the payment of all fees and charges.I shall be responsible

for my ward's conduct and good behavior during the course for the entire period till he/she gets the degree.

There is no necessity for MSRIT to inform further regarding these matters.

Date : Signature of the Parent

Place :

.............................................................................................. to SIS No dt

DECLARATION BY THE STUDENT

1. I declare that particulars and information furnished on pages 1 & 2 are fully correct.

2. I declare that I have Passed the bsc Examination conducted by Ytr Board / University Hgfhg state during 2007 and secured 64.08% of

marks in aggregate

3. If there is any false information/fake certificate or any forgery in the particulars / certificates / documents submitted by me to the

authorities of MSRIT /University, my admission may at once be cancelled and necessary action may be taken.

4. I do understand that, my admission at MSRIT is provisional and subject to approval of the VTU,Belgaum.

5. I Promise to abide by the rules and regulations of the Institution and the University, and I can be subjected to disciplinary action, if need

arises,and also I can be dismissed from the college, if I am found not obeying the rules and regulations

6. I agree to adhere to Rules and Regulations, Scheme of study and Examinations of the Autonomous Institute, affiliated to Visvesvaraya

Technological University, Belgaum.

7. I do not indulge in ragging in any of the forms.

8. I do know that the mobile phones are banned in the college campus. I do know that, I should come with decent dress to the college. If I

fail to do so suitable action may be taken against me.

Date : Signature of the Candidate

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The following instructions are to be followed by you before filling the Application Form. Hence, you are requested to act

to it.

1. You are informed to keep sufficient number of copies of all the certificates including Admission Order before submitting the

original certificates. Once Original certificates submitted will not be returned till the Admission is approved by the University.

2. You will require these certificates to apply for Scholarship/ Bank Loan/ Education Loan/Passport etc. Original documents will

be returned to the candidate during the II/III Year UG / PG Courses only.

3. The students of both UG and PG courses, who are eligible for the Scholarship/Fee Concession (All types of scholarships) are

hereby informed that the Government of India has introduced the new scheme of Direct cash transfer to the students. Hence,

students are hereby informed to open a Savings bank A/c. (Vijaya Bank, MSRIT Branch) and Aadhar Card is Mandatory for

availing the above benefits for the academic year 2016-2017. For further details, you may log on to website:

www.dcekar.nic.in

The PG Students who are Eligible for GATE Scholarship are required to open a Savings Bank A/c. in State Bank of India(SBI)

in any branch and Aadhar Card is Mandatory. In case of students belongs to SC/ST Category are required to submit the

Caste Certificate in English version only for availing the Direct Cash Transfer from AICTE.

4. If the candidate has obtained 90% and above in the qualifying examination (10+2) Exam, then you are eligible for merit

scholarship. For details, please log on to National Scholarship Portal.

5. If the candidate belongs to SC/ST category and selected the seat through KEA/PGCET, they can collect the Application for

Scholarship /Fee-reimbursement which is available in the Admission & Scholarship Section. The candidate is required to submit

the duly filled in Application with required attested copies of certificates to Admission Section within the stipulated date every

year during the month of August/September. Late application will not be accepted under any circumstances.

6. If the candidate belongs to SC / ST Category and your parents Annual Income is below or equal to Rs.2,50,000/ - you have

to register your name on the Social Welfare Department website. For any further information required, you may contact Social

Welfare Department, The Taluk Social Welfare Officer, Bangalore North Taluk, No.704, 'A' Sector, 6th Main Cross,

Yelahanka Upnagar, BANGALORE - 560 064 or Asst. Registrar, Admission & Scholarship Section.

7. In case of Non-receipt of Scholarship/Fee-reimbursement from Social Welfare Office / Director of Technical Education,

Government of Karnataka before Commencement of even semester examination, the candidate shall have to pay the fee

prescribed by our Institution before appearing to the even semester examination every year.

8. If you have selected through KEA-UGET/KEA-PGCET and belongs to CAT-1 (Parent Annual Income is less than or equal

to 2 Lakhs) and for IIA,IIB,IIIA & IIIB ( parents annual income is less than or equal to Rs.44,500 then you are eligible for

Fee-concession. For further details, you may log on to http://karepass.cgg.gov.in

9. There is also a provision for scholarship / financial aid from Government Department / Public Sectors / Pvt. Trusts/Agencies

for Merit Cum Poorer section of students, the list is announced on the notice board. Eligible candidates can apply when the



upon

according

WELCOME TO FRESHERS FOR THE ACADEMIC YEAR 2016-2017

INSTRUCTIONS

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application is called for.

10. You are strongly advised and informed to see the Main and Departmental Notice Board regularly. Please note that

late submission of Application with regard to Scholarship, Examination, Re-Registration etc., will result in losing the

benefits which the candidate is eligible.

11. You are not allowed to use mobile inside the campus.

12. You are informed to come to college with decent dress.

13. Keep your belongings safely. The college authorities are not responsible for any loss.

14. You should not indulge in any anti-social activities. You should not indulge in any ragging. You must abide by the

disciplinary norms stipulated by the college. If you violate these instructions, the college authorities have the right to take

suitable disciplinary action against you.

15. In case the student discontinues the course, at any time AFTER the LAST DATE of admissions, the student will have to

pay the fees for the remaining years of study and then obtain the original documents.

16. The classes for I Semester are likely to commence during First week of July / August 2016 (tentative). The exact date of

commencement will be announced on the website: www.msrit.edu

17. Please read and understand the Autonomous Rules and Regulations which are currently in force and are available

on website. In case of any doubt, please contact the Head of Department / Controller of Examinations / Registrar

(Academic) / Principal.

18. You are informed that you have to pay the Annual tuition fee every year during the month of July / August by D.D. drawn in

favour of INSTITUTE OF TECHNOLOGY, BANGALORE or through RTGS to our SB Account

141201011008909 IFSC VIJB 0001412 MICR: 560029070. If you do not pay the fees within the stipulated date, you will not

be allowed to attend the classes. In this regard, parents are requested to confirm from the Accounts Section, well in time,

whether the fees are paid in time by their wards. This is particularly important if the parents are sending the fees through their

wards so that they can avoid inconvenient to attend the classes / semester end examination by their wards.

19. Students who intend to change from Engineering course to other course on KEA(CET)/COMEDK allotment after the last date

of admission, will have to pay full four years fees if they are leaving MSRIT for any other institution.

20. The newly admitted students are hereby informed to submit the Visvesvarya Technological University undertaking on a

Judicial Stamp Paper of Rs.20/- and shall be sworn before notary and submit the same to the concerned department after

the commencement of the classes without fail.

We certify that we have read and understood the above instructions. We undertake to abide by the rules and regulations prescribed

by the Institute's authorities from time to time.


RAMAIAH

Signature of Student with Date Signature of Parent with Date

Name of the Student : Name of Parent :

Class & Branch : Contact Number with STD Code :

Quota / Category : Mobile Number :

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ACKNOWLEDGEMENT

Sl.No. Documents Original Copies

1 Stamp size photos YES YES

2 10th Marks Sheet YES YES

3 12th Std. Marks Sheet/s. YES YES

4 Admission Order PGCET/KMAT 1 plus 3 YES YES

5 Caster Certificate and Income Certificate (If claiming under SC/ST/1/2A/2B/3A/3B category) YES YES

6 Degree Marks Sheet YES YES

7 Diploma Marks Sheet YES YES

8 Migration Certificate(if studied other than PUC of Kar.) YES YES

9 PDC or Degree Certificate YES YES

10 QUALIFYING EXAM MARK SHEET YES YES

11 Study Certificate 7/10 Years YES YES

12 Transfer Certificate / College Leaving Certificate YES YES



Date : Signature

KEA/PGCET Hall Ticket No : KEA/PGCET Ranks No :

Received the following Original Certificates from Ms/Mr :

Admitted to M.B.A in : Sem : Semester Year :

Category :

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VISVESVARAYA TECHNOLOGICAL UNIVERSITY Page No. 9

Jnana Sangama, Belgaum-590 014 (Karnataka State)(Application form for Eligibility Certificate for M.Tech / MCA / MBA Coursesfor the year 2016-2017)

Note: Incomplete and incorrect application without required documents and fee will be rejected.

(To be applied by the candidate before seeking admission to the course in an affiliated college, along with prescribed fees (Rs.500/- for Karnataka candidates for MBA / MCA only. Rs.1,500/- for Non-Karnataka candidates and Rs.7,500/- for Foreign candidates for M.Tech / MCA / MBA) by DD on any Bank in favour of the Finance Officer, VTU, Belgaum)

2. The Course for which eligibility is sought :

4. Original statements of mark sheets, : Degree/Provisional Certificates Issued concerned University along with one set of attested copies to be enclosed (Originals will be returned after verification)

5. Prescribed fees paid : YES NO

Rs DD.No. DatedDay Month Year

Drawn on Bank & Place Bank Place

6. Details of Exams Maximum Marks Minimum Marks Obtained Marks

I hereby undertake to produce the Migration / Transfer Certificate within one month from the date of application to the University, failing which the eligibility / admission letter

issued to me may please be treated as cancelled.

Date Signature of the Candidate

Forwarded to the Registrar, VTU, Belgaum for necessary action.

This is to certify that the above information and enclosures are checked and found correct.

Signature of Principal & Seal


1. Name in full & Address for Correspondence :

3. Qualifying examination passed : 1. Degree :2. Month/Year of Pass :

3. Final exam Roll No. : 4. Name of University :

First Semester 700 315

Second Semester 700 315

Third Semester 700 315Fourth Semester 700 315

Fifth Semester 700 315

Sixth Semester 700 315

Seventh Semester 700 315

Eighth Semester 700 315

Ninth Semester 700 315

Tenth Semester 700 315

Total 7000 3150

Percentage

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VISVESVARAYA TECHNOLOGICAL UNIVERSITY Page No. 10

Jnana Sangama, Belgaum-590 014 (Karnataka State)(Application form for Eligibility Certificate for M.Tech / MCA / MBA Courses for the year )

1. P.U.C Marks Card :

2. Degree Marks cards of all the Years :

3. Rs DD.No. DatedDay Month Year

For Office Use Only

Remarks : Office Superintendent :

Case Worker : Special Officer :

A.O.S : Registrar :


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APPLICATION FOR TRANSFER CERTIFICATE

To : Bangalore

The Principal, Date :

Sir/Madam,

SUB: Issue of Transfer Certificate

Signature of the Candidate

MSRIT/TC/No. Date: .............

PRINCIPAL


Through:

The Principal

RAMAIAH INSTITUTE OF TECHNOLOGY,

Autonomous Institute, Affiliated to VTU,

RAMAIAH INSTITUTE OF TECHNOLOGY,

MSRIT Post

Bangalore-560 054

I have been admitted to in at RAMAIAH INSTITUTE OF TECHNOLOGY

MSRIT Post, Bangalore-560054 provisionally subject to the production of my Transfer Certificate. The particulars during my stay in your

college are given below.I request you kindly to send my Original Transfer Certificate to The Principal, RAMAIAH INSTITUTE OF

TECHNOLOGY (Autonomous Institute, Affiliated to VTU) MSRIT Post, Bangalore -560 054.

If i have to pay arrears to the college, same may kindly be communicated to me.

Name :

Father name :

Data of Birth :

Class & year of Admission to your college:

Class, Section & year in which I was studying at the time of leaving your college : ..............

Subject / Degree Studied in the college

Examination passed : ........... Reg.No : ..................... Month/Year : ................

Date : Yours faithfully

Place :


(Autonomous Institute, Affiliated to Visvesvaraya Technological University, Belgaum)

RAMAIAH INSTITUTE OF TECHNOLOGY,MSRIT Post,Bangalore560 054.

Forwarded to the Principal with a request to issue Transfer Certificate in person or send by Reg. Post at an early date.The Branch/Course

may kindly be mentioned in the covering letter while sending the Transfer Certificate,to which admission is taken in this college by the

candidate .

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