Escolar Documentos
Profissional Documentos
Cultura Documentos
Instructions:
1. Fill your address in the address slips supplied and Registration Memo supplied.
2. Enclose self attested photo copies of marks card and other documents.
3. Candidates are appearing for the final degree exam of May/
June 2015 may also apply provided they can produce proof of their eligibility
for admission by September 15, 2015.
a. Permanent:
b. Correspondence
4. Occupation of Father/Mother/Guardian
Annual Income
1
Caste/Subcaste
Yes / No
SC / ST / OBC
c. Place of domicile
d. Nationality
6.
Yes / No
f.
Yes / No
7. Academic Record:
a. i. Qualifying Degree Examination Passed
iv. University
II Year
III Year
Marks obtained
I Sem.
II Sem.
III Sem.
IV Sem.
V Sem.
VI Sem.
Max. Marks
Percentage
Class/ Division
9. DECLARATION OF CANDIDATE
I hereby declare that to the best of my knowledge, the particulars furnished in this application are correct.
I am willing to forfeit the seat secured, if any information provided by me is false.
If selected for admission, I undertake to abide by the regulations of admission and Rules of the Institute, and the
Academic Regulations that govern the programme of study.
Place:
Date:
Signature of candidate
Two Self-Addressed Envelopes with Stamp each worth Rs 17/- (For postage in Mangalore) / Rs 39/- (for Postage outside
Mangalore).
Institute/Organization
from
..
and
has
..
years
of
experience
(teaching/R&D/industry).
1.
He / She is sponsored (deputed) with full/half/no salary (Strike-out whichever is not applicable), for full time study
in National Institute of Technology Karnataka, Surathkal.
2.
The candidate and his/her sponsorship (deputation)/ NOC will not be withdrawn before the completion of
the course/programme.
Office Seal
Station:
Date :
Name:
Designation:
(Note: Sponsorship certificate should be submitted in the same format as indicated in this application form
duly signed by the Employer/ Sponsoring Institute Head and seal.)
3
REGISTRATION MEMO.
Date:......... 2015
Ref: Application for admission to M.Sc.(Physics) Programme
The Registration No. assigned to your application for admission is noted below, which must be quoted in all
correspondences connected with your application. No notice will be taken of any communication or document sent by you
unless it bears your Registration Number.
Registration Number:
M.Sc.(Physics) ........../2015-2016
Affix
Stamp
Rs.6/To:
The Asst. Registrar (Academic),
Mr./Ms. ________________________
N.I.T.K., Surathkal
______________________________
Post Srinivasnagar
_______________________________
_____________________________
To:
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
To
To:
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
BY REGISTERED POST
ADMISSION 2015
From:
To:
____________________________
____________________________
N.I.T.K., Surathkal
____________________________
Post Srinivasnagar
____________________________
____________________________