GOVT.

OF NCT OF DELHI

DELHI TECHNOLOGICAL UNIVERSITY

Application No. .. (for office use) (Formerly Delhi College of Engineering) Shahbad Daulatpur, Main Bawana Road Delhi 110 042

B. TECH. (EVENING) ENTRANCE EXAMINATION- 2014 (Last date for receipt of completed application form: 30.05.2014, 7.00pm)

Note: Before filling in the columns below, read carefully the instructions. Roll No. (To be filled in by office ) Branch Code (Circle One) Category Code (Circle One) Please paste (do not staple) a recent passport size photograph in this space duly self attested

CECE CEME OPEN SC

CEEE

CEEC CEIT STAFF PWD

ST OBC

Name (Block Letters ) S/o or D/o or W/o:...................................................................................................... Local Mailing address (with Contact No).:. Name of Institution / Organization where employed (with Contact no.) ....

Signature of the candidate

Coordinator

GOVT. OF NCT OF DELHI

DELHI TECHNOLOGICAL UNIVERSITY

(Formerly Delhi College of Engineering) Application No. .. Shahbad Daulatpur, Main Bawana Road (for office use) Delhi 110 042 B.TECH. (EVENING) ENTRANCE EXAMINATION- 2014 ADMISSION TICKET

Name (Block Letters):

Roll No. Branch Code Category Code Please paste (do not staple) a recent passport size photograph in this space duly self attested

(Roll No. to be filled in by the Office) Date of Examination Time of Examination Centre : 29.06.2014 (Sunday) : 9.00 a.m. : Delhi Technological University, Shahbad Daulatpur, Main Bawana Road, Delhi-42.

Signature of the candidate

Coordinator 1

INSTRUCTIONS:
1. Read the Bulletin of Information carefully before filling in the Application Form. Incomplete applications will be summarily rejected. 2. Fill up all the columns neatly. Your signatures are essential at all relevant places. The application is liable to be rejected if any of the items is left incomplete. 3. Attested Photocopies (by Gazetted Officer) of original certificates, including SC/ST/OBC/PWD certificate and work experience certificate, must be attached along with the application form. All original certificates are required to be produced at the time of admission. 4. The completed application is to be submitted on or before 30-05-2014 (Friday) to the Dy. Coordinator (Admn.), B. Tech. (Evening) Entrance Examination, latest by 7.00 PM in B.Tech.(Evening) Office, 1st Floor, FW1-FF4 Electrical Engineering Department, Delhi Technological University, Shahbad Daulatpur, Main Bawana Road, Delhi-110042.

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Note:
1. 2. Schedule of the Entrance Examination along with instructions is enclosed herewith. Each candidate must show his/her Admission Ticket to the Superintendent of the Entrance Examination for admission to the Examination centre. Candidate may be required to produce the Admission Ticket any time during the course of the conduct of Examination. 3. Admission of a candidate to the Entrance Examination is absolutely provisional subject to their being found otherwise eligible for admission to the course concerned. 4. The candidate must retain admission ticket as it is to be produced along with other documents at the time of admission. Candidate Address :

To, NAME: .... ADDRESS: . ..PIN ... PHONE(M):.(R): ..

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GOVT. OF NCT OF DELHI

DELHI TECHNOLOGICAL UNIVERSITY

Application No. .. (for office use) (Formerly Delhi College of Engineering) Shahbad Daulatpur, Main Bawana Road Delhi 110 042

Application Form for Admission to B. TECH. (Evening) DEGREE PROGRAMME- 2014

Read the instructions given in the Bulletin of Information carefully before filling this Form. Fill up all the columns completely. Your application is liable to be rejected, if any of the items is unfilled or incomplete. Please paste (do not staple) a recent passport size photograph in this space duly self attested

Roll No.

Branch Code

Category Code

Marks in Ent.Exam

(To be filled in by the office) Details of Bank Draft:

Draft No:..Date:Amount: Issued By:..

1. 2. 3. 4. Name (in Block Letters ): . Fathers/Husbands Name:. Sex(Male / Female ):.. Date of Birth (in figures ): Age as on 30-08-2014 : Years.Months.Days Shortage in Age, if any: Years.Months.Days (Refer to Section 4. Eligibility Conditions) Nationality (a)Local Mailing Address:................................................... --------------------------------------------------------------------------.PIN . Contact No.:(i) Mobile No. ..(ii) Telephone No.with STD code, if any. (b) Permanent Home Address:.... PIN:. (c) Valid email id: ..Contact No...... Branch Code (i) Civil Engg. (CECE) (ii) Mechanical Engg. (CEME) (iii) Electrical Engg. (CEEE) (write only one Branch Code) (iv) Electronics & Communication Engg. (CEEC) (v) Information Technology (CEIT) Category Code General (GEN) Scheduled Caste (SC) Scheduled Tribe (ST*) Other Backward Classes (OBC) (write category Code) Staff of Directorate Tech. Education Govt. of NCT (STAFF) (Staff of DTU, NSIT, Polytechnics & I.T.Is) Persons With Disabilities (PWD) (If a candidate belongs to the SC/ST*/OBC/PWD category an attested photocopy of the relevant certificate must be attached with the application form) *-If ST reservation is provided as per the policy of Govt. of Delhi

5. 6.

7.

8.

9.

10.

Are you an employee of an Institution under the direct control of Department of Technical Education, Govt. of Delhi? Yes / No. If Yes, Name of the Institution where employed. (A) Details of examinations passed. Class/Branch Board/ University School/College Year of Passing Aggregate % marks

Examination Secondary School (X) Senior Secondary (XII) State Board Diploma

(B) (i) Details of marks secured in Diploma Course as per semester wise: Branch Year/Semester Marks Secured (x) Max Marks (y)

Total (Attach photocopies of all certificates & mark sheets) % age of the above =
.

100 =

11.

Details of Employment:.
S Name of Organisation Post held Nature of Duties Experience From To Place of Work No. with Address & Tel. No.

Total Experience after passing diploma: . Years

.. Months

(Attach supporting documents of Work Experience with the present & the previous employers)

12. 13.

Annual Income of Self:. List of documents attached (i) (ii) (iii).. (iv) (v) (vi) 4

14.
1.

Undertaking:
I hereby certify that the particulars given above are correct and I agree that my admission, if granted, will be on the terms, conditions, and rules given in the latest edition of the University prospectus and as per the acts and statutes and ordinances of the Delhi Technological University or such modifications thereof as may be made from time to time by the authorities concerned. I understand that my admission may be cancelled and entire fee paid by me be forfeited, if any of the particulars given by me in this application are subsequently found to be wrong. I agree that the decision of the Vice Chancellor, DTU in all matters concerning my admission, studies, discipline and conduct will be final and binding on me. I undertake to submit myself to the disciplinary jurisdiction of the Vice-chancellor and the authorities of Delhi Technological University, according to the Acts, Statutes, the Ordinances, and the Rules that have been framed by Delhi Technological University, and also the Rules that would be framed by the Board of Management of Delhi Technological University from time to time. I understand that my association, active / passive, with unlawful organisations is forbidden. I have not registered with the Delhi Technological University for any other degree. I further certify that I have not registered as provisional or regular student of any other University also. I agree that the University shall have the right to forfeit the security deposits inter-alia on the ground of my failure to claim the refund within three years of my ceasing to be on the rolls of the college. I shall not seek hostel accommodation during the course of my studies in the University.

2.

3. 4.

5.

6.

Signature of Applicant

NO OBJECTION CERTIFICATE FROM THE EMPLOYER Name of Organisation: ________________________________________________________________ Address: ____________________________________________________________________________ ____________________________________________________________________________________ Phone No :__________________________________________________________________________ Email Address: ______________________________ Website: _________________________________ 1. Mr./MsS/o or/ D/o or W/o is employed as . 2. 3. He/She joined this Organisation on.. He/She is hereby permitted to join the B. Tech. (Evening) Programme at Delhi Technological University. 4. The Nature of his/her duties are. 5. He/She will be allowed to attend the classes at Delhi Technological University from 6.00 p.m. onwards on working days and during day time on public holidays/Saturday/Sunday. 6. His/her conduct and character have been found to be satisfactory.

Date: ____________ Signature & Designation of Competent Authority (with Seal)

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ACKNOWLEDGEMENT CARD
To be filled by Office Application No:

Received Application Form for B. Tech. (Evening) Entrance Exam.-2014 Branch Code (CECE/CEME/CEEE/CEEC/CEIT) From:Dy. Coordinator (Admn.) B. Tech. (Evening) Entrance Exam-2014 Delhi Technological University, Shahbad Daulatpur, Main Bawana Road, Delhi 110042

SPEED POST
Affix Rs.15 postage stamp, if sent by post

To ____________________________________ ____________________________________ ____________________________________ ____________________________________ PIN CODE ____________________

BLANK

Mailing Address:
NAME: ... ADDRESS: .. ..PIN .. PHONE(R):.(M): .. ______________________________________________________________ NAME: .... ADDRESS: . ..PIN ... PHONE(R):.(M): .. ______________________________________________________________ NAME: .. ADDRESS: . ..PIN .. PHONE(R):.(M): .. ______________________________________________________________ NAME: .. ADDRESS: . ..PIN .. PHONE(R):.(M): .. ______________________________________________________________

(Name and Address should be neatly written in Block Letter) Note: Write your local Mailing address and telephone number for any urgent query. Attach this page with the main application form.