National Institute of Food Technology Entrepreneurship and Management

Deemed to be University (De-novo Category) under Section 3 of the UGC Act, 1956 and an Autonomous Institution under Ministry of Food Processing Industries, GOI

Plot No. 97, Sector-56, HSIIDC Industrial Estate, Kundli-131 028, Distt.-Sonepat (Haryana)

Application Form for Admission to B Tech Programme:2014-15

PERSONAL DETAILS
Application Ref. No. : 11755
Internal ID

: 21695

Full Name

: ANJALI SHARMA

Coloured Photo

Father's Name

: PK SHARMA

Identical to the

Mother's Name

: KUSUM SHARMA

one given with

Date of Birth

: 16/03/1997

Gender

: FEMALE

Category

: GENERAL

Application Form

Physically Handicap : N

Nationality:

INDIAN

Religion:

HINDU

Kashmiri Migrant:

Address for Correspondence:

Mohalla/Street: GIRITAL COURT ROAD

District

: 819
: KASHIPUR
: UDHAM SINGH NAGAR

E-mail ID

: pawan.k.sharma@indiaglycols.com

Country:

Contact No.

: 9690100029

Passport:

House No.
Place/Village/City

Pin:

244713

State:

Uttarakhand

EDUCATIONAL DETAILS
Examination
Passed

Subject/Branch

Board/University

Year of Passing

Marks Obtd.

Marks (%)

PLUS TWO

PHYSICS,CHEMISTRY,M
ATHS,ENGLISH,PHYSIC
AL EDUCATION

CBSE

2014

451

90.2

JEE(Main)- 2014 Roll No.: 72800036

Remarks (Not to be filled

by the Applicant)

(Attach photocopy of JEE 2014 admit card with hard copy of application)

Application fee Details (if not submitted online)

Bank

Amount

Dated

DD No.

250.00

Undertakings by the Candidate:

I hereby certify that the foregoing particulars are correct. I understand that my admission may be cancelled and total fee paid by
me may be forfeited if the particulars given by me in this application are subsequently found to be wrong.
I agree that institutes rules and decisions thereby in all matters concerning my admission, studies, discipline and conduct will be
final and binding on me.

Date: ___/ ___/ 2014

(Signature of Applicant)

Undertakings by Parents / Guardian

I testify that my son / daughter / ward .......................................... is seeking admission with my consent and I am personally
responsible to the University for payment of all his/her dues. I assure that the applicant will abide by the rules of the University.

Date: ___/ ___/ 2014

(Signature of Parent/Guardian)

National Institute of Food Technology Entrepreneurship and Management

Deemed to be University (De-novo Category) under Section 3 of the UGC Act, 1956 and an Autonomous Institution under Ministry of Food Processing Industries, GOI

Plot No. 97, Sector-56, HSIIDC Industrial Estate, Kundli-131 028, Distt.-Sonepat (Haryana)

Application Form for Admission to B Tech Programme:2014-15

Note: 1. In case of payment through DD, a printed copy of the application form along with the DD, must reach Head, Admission
Cell, NIFTEM, Plot No. 97, Sector 56, HSIIDC Industrial Estate, Kundli 131028, Distt. Sonepat, Haryana, on or before 27th
June 2014.
Note: 2. You must upload your JEE (Main) All India Open rank within 3 days of its announcement by C.B.S.E.