applicatinformcolour - punsumi.com · The form must be filled in students's own handwriting in...
Transcript of applicatinformcolour - punsumi.com · The form must be filled in students's own handwriting in...
INSTRUCTIONS
1. The form must be filled in students's own handwriting in BLOCK LETTERS.
2. Every entry in the form must be filled in correctly. Incomplete form will not be considered.
3. On scrutiny of the original documents if any discrepancy, incorrectness or any proof of tampering with the marks is noticed, the form will be summarily rejected and the admission, if given, will be cancelled.
Form No : JIET/AF/1
JIET Universe, N.H.-65, Pali Road, JODHPUR-342 002 (Raj.)
Ph. 0291-2868152/53, 5170917/18
email : [email protected] • website : www.jietjodhpur.com
• Jodhpur Institute of Engg. & Technology (JIET)
• JIET School of Management (JIET SOM)
• JIET School of Engg. & Technology for Girls (JIET SETG)
• JIET School of Management for Girls (JIET SOMG)
• JIET College for Girls (JIET CG)
Application Form for Admission to _____________ Year_____________________Course
Name of the College_________________________________________________________
Photo
(A) Personal information
1. Name of the student in full Mr./Ms..............................................................................................................................(IN BLOCK LETTERS) NAME SURNAME
2. (a) Date of Birth
(b) Sex
Session 20_____ - 20_____
JIET GROUP OF INSTITUTIONSJIET GROUP OF INSTITUTIONS
TTI US TNI IOF NO S,P JU OO DR HG P
T U
E RIJ
Date Month Year
Male Female
A CONSTITUENT OF ARUN SHANTI EDUCATION TRUST, JAIPUR
1
3. (a) Religion..........................................................................(b) Nationality........................................................................
4. Blood Group...............................................................................................................................................................
5. Category (SC/ST/OBC/GEN/PH/Any other, Specify)..................................................................................................
6. Certificate as proof of above mentioned category........................................................................................................
7. Admission Category (RPET/AIEEE/RMAT/Management/Direct/Open Merit).............................................................
8. RPET/AIEEE/RMAT Roll No......................................................................................................................................
9. RPET/AIEEE/RMAT Rank ........................................................................................................................................
(B) PARENTS DETAILSAND OTHERS :
1. Father's Name Occupation Organization/Department Designation
(govt. / Private /Self Employed)
............................................ ................................................ ........................................ .....................
Mother's Name Occupation Organization/Department Designation
(govt. / Private /Self Employed)
.......................................... ................................................ ........................................ ......................
Father's / Mother's present residential address :
..................................................................................................................................................................................
..................................................................................................................................................................................
Tele.: STD code ........................Office No.................... Residence No.................... .......Mobile.................................
Email Id :....................................................................................................................................................................
2. Local guardian / reference Relationship.....................................................
NAME Occupation Organization/Department Designation
(Govt. / Private / Business)
............................................ ...................................... ................................ ..........................
Present residential address of local guardian.
.................................................................................................................................................................................
..................................................................................................................................................................................
Tele.:STD code..........................Office No.......................... Residence ................................Mobile...........................
Email Id :....................................................................................................................................................................
2
c. Name of the Qualifying Course (for UG/PG)
NA
NA
NA
d. Subject Combination
e. Roll No.
f. Certificate No.
g. Medium (Hindi/ English)
h. Maximum Marks
i. Marks obtained
j. Percentage
3. Present residential address of student if different from B 1& B 2
.........................................................................................................................................................................................
.........................................................................................................................................................................................
will you avail the transportation facility : Yes No
will you avail the Hostel facility : Yes No
3
SecondarySchool
Examination(X Class)
Sr. SecondarySchool
Examination(XII Class)
(Applicable for PG Course)
GraduationPost
Graduation
(C) ACADEMIC RECORD
b. STREAM
a. Name of the Board/University
4
3. Specify if having knowledge of any foreign / Indian Language (other than Hindi, English, Rajasthani)................................
MaximumMarks
MarksObtained
MarksObtained
MaximumMarks
I Year II Year III Year Total Percentage
Physics &Chemistry Maths Total Percentage
For
B.E
.
RPET/AIEEE
MaximumMarks
MarksObtained
For
MB
A/M
JMC
Graduation
.......................Stream
Post Graduation(Degree/Dip.)
.......................Stream
RMAT
MaximumMarks
MarksObtained
MaximumMarks
MarksObtained
MaximumMarks
MarksObtained
Percentage
ExaminationName of
The OptionalSubject
1 2 3
Total Percentage
XII
.......................
Stream
App
licab
leto
all
Diploma
........................Branch
I Year II Year III Year Total Percentage
Optional Subjects :1.......................................
2.......................................
3.......................................
DECLARATION & AGREEMENT BY THE STUDENT :
I,............................................... S/o D/o Sh...................................................... Branch/Course.................................................
..................................................................................................................................................................(Name of Institution)
declare-
(i) that I have read all the rules governing admission to the first/second year...................course in the college and have filled in the application form after thoroughly understanding these rules.
(ii) that the information filled in by me in the application form is true to the best of my knowledge and belief.
(iii) that any error made by me in the calculation of marks/age for evaluation of eligiblity as specified in the rules of admis- sion is my sole responsibility.
(iv) that I have not been debarred from apprearing in any examination held by any Government constituted or statuory examination authority in india or abroad.
(v) that I shall not indulge in any form of ragging or indiscipline and shall strictly abide by the rules of conduct. I shall also fullfill the criteria of 75 % Attendance for being eligible for appearing in internal/university examination.
(vi) that no other document other than those attached with the application form will be entertained for the purpose of claim / concession / weightage etc. in connection to my admission.
I agree
(i) that the admission granted to me is on a purely provisional basis subject to confirmation by the University/stategovernment/admission regulatory authorities.
(ii) to conform to the rules and regulation at present in force or that may hereafter be made for the governance of the College and Hostel. I further undertake that so long as I am a student of the College I will do nothing, either inside or outside the College and Hostel, that will interfere with their orderly governance and discipline.
(iii) that the Principal/Director of the College will have full liberty to expel me from the College or Hostel for any infringement of the above undertaking.
(iv) to execute an Agreement as prescribed by the management at the time of admission to the College and Hostel.
Date.................................. Signature........................................
DECLARATION & AGREEMENT BY THE PARENT :
I,.................................................................................. ward of..................................................................................... declare (Name of the Parent)that the information given by my son / daughter is true and correct to the best of my knowledge. I have gone through the rules governing the admission and conduct of my ward in the college and I agree to abide by the decision of the Management.
Date........................ Signature........................................
Name..............................................
TTI US TNI IOF NO S,P JU OO DR HG P
T U
E RIJ
5
JIET Universe, N.H.-65, Pali Road, JODHPUR-342 002 (Raj.)
Ph. 0291-2868152/53, 5170917/18
email : [email protected] • website : www.jietjodhpur.com
JIET GROUP OF INSTITUTIONSJIET GROUP OF INSTITUTIONSA CONSTITUENT OF ARUN SHANTI EDUCATION TRUST, JAIPUR
S. No. Name of Document
X Marksheet
XII Marksheet
RPET/RMAT/AIEEE Marksheet
Transfer Certificate
Character Certificate
Migration Certificate
Photographs (Passport Size)
Category / Caste Certificate
Medical Certificate
Domicile Certificate
Proof of Date of Birth(If Not mentioned in XMarksheet/Certificate)
Original (Yes/No) No of Copies
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
List of certificates enclosed :
TTI US TNI IOF NO S,P JU OO DR HG P
T U
E RIJ
Signature of Student
Pending Documents :
1.
2.
3.
4.
Remarks :_________________________________________________________________________________________
_________________________________________________________________________________________________
Date :______________________ Form Checked by :______________________________
Approved for Admission :_________________________
6
JIET Universe, N.H.-65, Pali Road, JODHPUR-342 002 (Raj.)
Ph. 0291-2868152/53, 5170917/18
email : [email protected] • website : www.jietjodhpur.com
JIET GROUP OF INSTITUTIONSJIET GROUP OF INSTITUTIONSA CONSTITUENT OF ARUN SHANTI EDUCATION TRUST, JAIPUR
To be filled by student:
1. Name of student (in full) Mr. / Ms.......................................................................................................................................
2. Father's / Mother's Name...................................................................................................................................................
3. Address..............................................................................................................................................................................
...........................................................................................................................................................................................
...........................................................................................................................................................................................
4. Tel. No. : Residence..........................................Office...........................................Mobile No............................................
5. E-mail ID............................................................................................................................................................................
I.....................................................................................S/o D/o Sh.......................................................................................dohereby undertake to abide by all the rules and regulations framed by the College from time to time for availing transport facility
by the College during the session.......................................I shall continue this facility during the whole session. In case, I
decide to discontinue in between, I shall not claim refund of annual transport fees.
Further, I do undertake to maintain proper decorum in the bus and always keep the transportation card in my possession while
traveling in the bus, so that the same can be shown to the authorities on demand. If I am found guilty in any indiscplinary act in
the bus, management of the college will have full liberty to take apropriate action against me.
Photo
Name of the College : __________________________________________________________
Course :_____________________________________________________________________
Year/Sem./Branch :
Pick up Point :
Session 20____ - 20____
Signature of StudentSignature of Parent
Date........................
TTI US TNI IOF NO S,P JU OO DR HG P
T U
E RIJ
7
JIET Universe, N.H.-65, Pali Road, JODHPUR-342 002 (Raj.)
Ph. 0291-2868152/53, 5170917/18
email : [email protected] • website : www.jietjodhpur.com
JIET GROUP OF INSTITUTIONSJIET GROUP OF INSTITUTIONSA CONSTITUENT OF ARUN SHANTI EDUCATION TRUST, JAIPUR
APPLICATION FORM FOR COLLEGE TRANSPORATION
Photo
Name of the College : __________________________________________________________
Course :_____________________________________________________________________
1. Name of student (in full) Mr./Ms.
2. Father's/Mother's Name
3. Permanent Address
Tel. No. STD Code (R) (O) Mobile
Email Id :
4. Local Guardian's Name & Address
Tel. No. (R) (O) Mobile
5. Email Id :
6. Mention if suffering from any Chronic Diseases or allergy (If yes furnish detail)
Signature of Parent / Local Guardian
Yes I want to take admission in JIET Hostel and I undertake to abide by all rules and regulations of JIET.
Signature of Student
APPLICATION FORM FOR HOSTEL ACCOMMODATION
Session 20____ - 20____
To be filled by student :
TTI US TNI IOF NO S,P JU OO DR HG P
T U
E RIJ
Year/Sem./Branch : Name of the Hostel :
Reg. No. : Room No. :
9
JIET Universe, N.H.-65, Pali Road, JODHPUR-342 002 (Raj.)
Ph. 0291-2868152/53, 5170917/18
email : [email protected] • website : www.jietjodhpur.com
JIET GROUP OF INSTITUTIONSJIET GROUP OF INSTITUTIONSA CONSTITUENT OF ARUN SHANTI EDUCATION TRUST, JAIPUR
(1) No student is allowed to stay back in the hostel without prior permission of the warden during
college hours.
(2) All the students residing in the boys and girls hostel shall be permitted to leave the College Campus only on the written permission (Outpass for Hostellers) of the warden.
(3) All students residing in the hostel shall ensure that they pay the hostel fees within the stipulated time. Those who do not pay the dues in time shall have to pay the dues with fine as per rules, failing which they will be debarred from the hostel.
(4) All students shall ensure the minimum attendance level of 80% required to stay in the hostel.
(5) The visiting hours for the college are from 3:30 p.m. to 7:30 p.m. Underno circumstances students shall take their visitors / guest to their hostel rooms.
(6) No students staying in the hostel is permitted to use Stove, Heater, Iron, Cooler,Immersion rod etc.
(7) Students are not permitted to smoke, consume alcoholic drinks. Use or possession of any kind of narcotics / drugs is strictly prohibited and will attract strict action.
(8) It shall be ensured by all students that they do not get involved in fighting among themselves. They shall not indulge in any form of ragging or act of indiscipline and shall strictly abide by the code of conduct.
(9) All students shall ensure that they adhere to the rules of dining hall as prescribed by the management.
(10) All students shall ensure that all the lights and switches are putt off when not in use and that any damage to the electrical fittings shall be dealt by imposing penalties as per norms.
(11) All students shall ensure that the furniture items issued to them for their use inhostel rooms are used with care. If any furniture is damaged, the charges will be recovered from the student.
(12) The students can meet the Warden in hostel office to resolve issues related to academic or administrative matters.
(13) College Management will not be responsible for any damage/loss of any item like computer,laptop, mobile etc. of hostellers.
(14) Any damage to fittings & accessories in the rooms as well as in common area of hostel, will attract individual/collective penalty.
(15) All students shall ensure that any violation of above rules shall be considered as an act of serious in decipline and defaulters may face severe action including termination from the hostel.
JIET RULES AND REGULATIONS (HOSTEL)
10