Homi Bhabha National Institute

Regd. Office: 2nd Floor, Training School Complex, Anushaktinagar, Mumbai 400 094

Enrolment Form for Admission to M. Tech. Programme

Year 20.-- 20.
Affix recent
self attested
photograph
3.5x2.5 cm

Part A : Application
(To be filled at the time of joining Training School)

Enrolment No (To be allotted by HBNI)

I desire to enroll in HBNI as a regular student to the MTech programme in Engineering sciences.
1. Applicants Full Name (in block letters as per Std XII)
(Mandatory to write name in Hindi also)

2. Date of Birth (DD/MM/YYYY)

3. Fathers / Mothers Full Name
4. Male/ Female
5. Nationality
6. Category
(General/ SC/ ST/ Others(specify))

7. Address for Correspondence with contact no.

Mobile no.
8. Permanent Address with contact nos.
9. Email ID (in block letters)
10. Whether Physically/ Visually Challenged
(Yes/No, if Yes give details)
11. Educational Qualifications (starting with graduation degree) (Attach attested copies of all Mark Sheets, Degree & Date of Birth Certificates)
S. No.

Degree

Year

% Marks

12. Location of BARC Training School

Subjects

Batch no.

University

Discipline

Certified that I am not enrolled in any other Programme of any University. The above information furnished by me is true and correct. If any information is
found to be incorrect or false, I understand that my admission shall be liable to be summarily terminated without notice.

Date:

Signature of Candidate
Through: Head, Training School with stamp

To Dean, HBNI
Version approved during the meeting of Standing Committee of Deans held during 29-30 Nov 2013

Homi Bhabha National Institute

nd

Regd. Office: 2 Floor, Training School Complex, Anushaktinagar, Mumbai 400 094

Part B : Divisional Approval for M.Tech.

(for those who have filled Part-A of MTech form)
Year 20- 20
Enrolment No (To be filled by the student)

a. Particulars of Employment

Unit Name
Division Name

b. Constituent Institution (CI)

where research work to be done

CI Name

BARC/IGCAR/RRCAT/VECC

1. Full Name (as per Standard XII)

2.

Date of Completion of one year course work at TS

(DD/MM/YYYY)

3.

% Marks Scored in Training School*

*Marks required for eligibility: 50% in Individual Subjects; 60% in Aggregate.
Attested copy of the Mark Sheet for one-year course work should be submitted with this form.

4. Address for Correspondence with Contact Nos. and

email ID
5. Project Details
Title of Project :
(enclose project proposal
duly signed by student,
guide, HoD)

Guide

Technology Advisor (if any)

Name
CI/Unit/Division
Email-ID
Address for Correspondence
with contact nos.

Certified that I am not enrolled in any other Programme of any University. The above information furnished by me is true and correct. If any
information is found to be incorrect or false, I understand that my admission shall be liable to be summarily terminated without notice.

Date:

Date:

Signature of Candidate

Name and Signature of Designated Authority with stamp*

* Head of the Division in which the applicant is working/Competent Authority of the Institution.
CHECK-LIST OF MANDATORY ENCLOSURES FOR APPLICANT
The fee (as applicable) to be paid in the form of crossed DD drawn in favour of: Accounts Officer, HBNI.
DD No.
Date
Drawn on Bank
Branch

Attested copies of Training School Marksheet and Training School Certificate.

Version approved during the meeting of Standing Committee of Deans held during 29-30 Nov 2013

Amount (Rs.)

Part C: Standing Committee Recommendation

Candidates Name

Discipline
Division

Guides Name
Unit
Certified that the total number of students registered currently under me is not more than 13 and not more
than 8 of these are Ph.D. Students. I have the permission of the competent authority to guide the student.
Signature of Guide:

Date:
Division

Technology
Advisors Name

Unit

Suggested composition of the M.Tech. Committee (to be filled up by CI)

Sr. No.
Designation
Name , Division, Unit
Chairman,
1.
MTech
Monitoring Committee
2.

Convener
(Guide)

3.

Member

4.

Member

5.

Member-Invitee
(Technology Advisor, if
any)

Certified that the above mentioned applicant has passed (at least

50% in Individual subjects & 60% in

aggregate) one-year course work of Training School.

or

The above mentioned applicant attended one-year course work of Training School. Applicant has failed
in ___ subject/s but has scored 60% in aggregate. Applicant is advised to appear for re-examination in
those subjects.

The student may proceed with MTech Project.

Convener, Standing Committee with stamp

Chairman, Standing Committee with stamp

Date:

Date:

Through: Dean-Academic, Engg Sc.

To: Dean, HBNI
Version approved during the meeting of Standing Committee of Deans held during 29-30 Nov 2013