Office : 0484 2463825

Fax : 0484 2463828

ADI SHANKARA INSTITUTE OF ENGINEERING & TECHNOLOGY
(AN ISO 9001: 2008 CERTIFIED INSTITUTION)
(Affiliated to Mahatma Gandhi University, Kottayam)
Vidya Bharathi Nagar, Kalady 683574
DL Post Box No. 1, Ernakulam Dist., Kerala.
E-mail : adishankara.net@gmail.com
Website : www.adishankara.ac.in
APPLICATION FOR ADMISSION TO THE B.TECH DEGREE COURSES 2014 - 2015
(Under NRI Quota)
Courses Offered :
a. Applied Electronics & Instrumentation
b. Computer Science & Engineering
c. Electronics & Communication RECEIPT NO. ....
d. Electrical & Electronics
e. Information Technology
f. Mechanical Engineering
g. Civil Engineering

1 Name of the Applicant (in Block Letters)

a) Sex


b) Religion & Caste


c)
Place of Birth
(Village/Town, District, State)

d) Age & Date of Birth


2 Branch Sought for in the order of priority
i)

ii)

3
Details of Engineering Entrance Examination
a)
State Entrance Exam Roll No. of the
Applicant

b) State Entrance Rank No. of the Applicant


c)
Marks secured in the Entrance
Examination

4
Name, Occupation & Address
Of Parent / Guardian
Phone No.
Mobile No.

5
Address for Communication
(in Block letters with Pin Code)

6 Contact Phone Number with STD Code



Academic Details (Attach attested copies of Mark Sheets, including marks obtained)

Name of Examination
passed
CBSE/ICSE/
State
Mathematics Physics Chemistry
Percentage
(PCM)
7 Plus two
8
Name of the Institution
last studied (+2 Exam or
Equivalent)

Total Marks
For +2
Percentage
9
Total Marks obtained in
10
th
Examination

10

Recommendation if any


11
Do you require Hostel
Accommodation?

12
Attach Photo copies of
extracurricular activities &
prizes won

13
Do you require Bus facility
if yes from where



Declaration :

I hereby declare that the particulars given in this form are true, complete and correct to the best of
my knowledge and belief.


Place :
Date : Signature of Guardian Signature of the Applicant

The duly filled in application form should reach the Principal before the stipulated date
The following documents are essential (only copies)
1. 10
th
Mark List
2. +2 or equivalent mark list
3. Entrance Rank Certificate, Mark sheet & Admit Card
4. Income Certificate if scholarship is to be availed

For further details contact :

Managing Trustee
Kochi
Ph : 0484-2351768

Adi Sankara Trust Ph:0484 2463825, 2461933, 2463828
Vidya Bharathi Nagar, Kalady P.O. Fax : 0484 - 2463828
Post Box No.1, Ernakulam Dist
Kerala, Pin : 683574