Sr. No.

:
No.: M.Tech/NSNT/.

FOR OFFICE USE

% of Marks in the Aggregate in
(i)

B.Sc (Hons.).%

(ii)

B.Sc (Gen. ).%

(iii)

JAM ...%

UNIVERSITY
UNIVERSITY OF DELHI
(FACULTY OF SCIENCE)

APPLICATION FORM FOR ADMISSION

ADMISSION TO THE
M.TECH COURSE ON NANOSCIENCE AND NANOTECHNOLOGY
FOR THE ACADEMIC SESSION 2013
2013-2014

Checked by..

This Application Form together with the Bank Demand Draft and
other enclosures must reach by 28th of June 201
2013, Friday
Friday.
day
Application must be completed in all respects.

Recent passport
size selfself-attested
photograph of
the Applicant

NOTE: USE ONLY CAPITAL LETTERS FOR FILLING THIS FORM

1. Name of the candidate:

(Name: Please do not write Mr./ Ms./ Sh./ Smt.)
FIRST
FIRST NAME

MIDDLE NAME

2. Male/ Female

SURNAME

F- For Female
M- For Male

3. Fathers Name:

4. Mothers Name:
Name

5. Category:
(Kindly write 1,2,3,4 or 5 in the given box)

1. General
2. OBC
3. SC
4. ST
5. Others (Please specify)
Y

6. Date of Birth
7. Postal Address: ____________________________________________________________________________________________
_______________________________________________________
______________________________________________________________________________________________________________
____________________________________________________________________________________________________
8. Telephone/Mobile
Telephone/Mobile No. ____________________
________________________
E-mail Id. ___________________________________________
________________
___________
_______ 9. E-

10.
10. Permanent Address: __________________________________________________________________
_____________________________________________________________________
_______________________________________________________________________
____________________
_________________
11.
11. State to which
which you belong__________________________ 12. Nationality_______________________
__________________________
___________________
_________________
13. College last attended ______________________________
______________________________ 14
14. University________________________
___________________________
______
_________________
15. Details of examination Passed: B.Sc.
B.Sc.(Hons.)/B.Sc
(Hons.)/B.Sc.
B.Sc. (Gen.)/Others_____________________________________________
Examination passed

10+2 or Equivalent
B.Sc (Hons.)
(Hons.)/B.Sc.
(Gen.)
Others

Name of
Board/
University

Roll
No.

Year

Marks with percentage

in aggregate
Marks.
Obtd.

Max.
Marks

% age

Division

Subjects studied

16. Whether the candidate qualified the JAMJAM-201

2013 Exam.
xam
16 a.) Percentile Score

Yes

No

16 b.)
b.) Ranking in Mark List

17. Details of M.Sc. Entrance, D.U.:

Physics/Chemistry _______________________________

Admit Card No. _________________

Marks Secured
Secured _____________________

18. Demand Draft No:

No: __________________
__________________________
_________________________ 19. Issuing Branch__________________
ranch____________________________________
____________________________________
20.
20. Name of the Bank _________________________________
______________________________________________________________
_______________________________________________
___________________________________________
________________
___
DECLARATION BY APPLICANT
1. I apply for registration as a 1st year student for admission to M.Tech course on Nanoscience and
Nanotechnology jointly offered by Department of Physics & Astrophysics and Department of Chemistry
under Faculty of Science of the University of Delhi for the academic session 2013-2014.
2. I agree to undergo the said course on full time basis and shall not engage myself in any other academic
course during the period of the course.
3. I have read the information bulletin/brochure and have noted its contents and direction for admission to
the 1st year M.Tech. Nanoscience and Nanotechnology Course for the academic session 2013-2014. On
admission, I shall submit myself to the disciplinary jurisdiction of the Vice- chancellor and the other
authorities of the University who may be vested with authority to exercise discipline under the Act, the
Ordinances and the rules that have been framed by the University of Delhi.
4. In the event of any information given by me is found wrong or suppressed, I will be liable to be punished
by the University of Delhi and cancellation of my admission to the said course.
Date: ___________________

______________________
(Signature of Candidate)

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------CHECK
CHECK LIST
Attested copies of the following certificates should be attached with the application form in the order given
below:
1. Mark-sheet of JAM 2013 Exam/ Proof of rank in M.Sc. Entrance Exam, D.U.
2. Detailed B.Sc. (H)/B.Sc. (Gen.)./Others Examination Mark- sheets.
3. Secondary School Certificate or equivalent certificate showing Date of Birth.
4. Character Certificate from the College last attended.
5. Two copies SC/ST Certificate duly attested (if applicable).
6. Entitlement Card issued by the Record Office of the Unit/Regiment, (if applicable)
Date: ___________________

______________________
(Signature of Candidate)
Candidate)

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------For Office Use

Sr. No.:
No.: M.Tech/NSNT/.

M.Tech Course on Nanos

Nanoscience and Nanotechnology
University of Delhi
Delhi
Delhilhi-110 007
ACKNOWLEDGEMENT SLIP
Received an Application Form from Mr./Ms. . for admission to M.Tech Course on
Nanoscience and Nanotechnology of the University of Delhi for the academic session 2013-2014.

Date: .

Signature of Office InIn-charge