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SASTRA UNIVERSITY
(A University under section 3 of the UGC Act, 1956)
THANJAVUR – 613 401, TAMIL NADU.
APPLICATION FOR ADMISSION TO B.Tech. / INTEGRATED M.Tech. PROGRAMMES 2010 - 11
(To be filled by the applicant in capital letters)
Language .......................
English
Mathematics
Physics
Chemistry
Elective ……………..
(specify the Name of the Subject)
Total
V SEMESTER VI SEMESTER
Marks Maximum Marks Maximum
Subject Subject
Scored Marks Scored Marks
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
6. 6.
Total Total
For online applications only: Please enclose Demand Draft for Rs. 650/- favouring SASTRA University payable at Thanjavur
Name of the Bank ....................................................................... Branch: ...............................................
D.D. No ................................................................................... Date : .............................
I hereby solemnly and sincerely affirm that the statement made and the information furnished by me
in the application as also in enclosures thereto submitted by me are true. Should it, however, be found that
any information furnished therein is untrue in material particulars or on verification at a later stage, I am
liable for criminal prosecution and I also agree to forego my seat in this Institution / for the removal of my
name from the rolls of the institution at whatever stage of study I may be at the time of detection of such
wrong particulars. I am also fully aware of the general instructions and I am bound by the same.
Place :
Date : Signature of the candidate
I am fully aware of the above declaration and I have understood the same. I agree to the above conditions.
Place:
Date : Signature of the Parent / Guardian
Note: The guardian can execute the above declaration, only if both the parents are not alive.
Academic Details :
Qualifying Exam Passed : ................................ Board of Study : .................................................................
Institution Name : ................................................................................................................................................
Register No. :.......................................... No. of Appearance(s) : .............. Month & Year of Passing : ........................
Total Mark Secured : ....................... out of ... .......................... Medium of Instruction : ........................................
AIEEE Roll No. (for AIEEE Candidates only) ............................................................... AIEEE Rank: ....................................
The 5-year integrated M.Tech. programme runs concurrently with B.Tech. programme (in paranthesis) till the
seventh semester, after which the student completes PG level courses in 8th & 9th semesters and project work
during the 10th semester.