App.

no :

M.A.M.COLLEGE OF ENGINEERING
(An ISO 9001-2008 Certified Institution)

Accredited by NBA, AICTE, New Delhi

M.A.M. Nagar, Trichy-Chennai Trunk Road, Siruganur, Tiruchirappalli 621 105. Ph: 0431-2650377, 2650549, 2650550 http://www.mamce.org/ Sponsored by MALUK EDUCATIONAL HEALTH AND CHARITABLE TRUST APPLICATION FOR ADMISSION TO M.E. / MCA / MBA PROGRAMME i. Read all the instructions carefully before filling up the application form ii. Mark in the appropriate box wherever applicable iii. Ensure that correct marks, age and community details are furnished by him / her in his/ her application form 1. Name (In block letters with initials at the end):___________________________________ 2. Address: Permanent Address: Address for communication: Space for Passport Size Photograph duly

PIN:

PIN:

3. Sex:

Male

Female

4. Date of Birth and Age:

Date

Month Year

5. Place of Birth: village / Town________________, District____________, State:__________ 6. a) Community: ST SC MBC/DNT BC FC

b) Name of Caste: ( In case of BC / MBC / SC / ST only) ____________________________ c) Whether NRI : Yes d) Whether Minority Muslim 7. Are you a Citizen of India? 8. i) Name of Father / Gaurdian ii) Name of Mother No (If yes, country:________________________) :Yes :Yes No No

:_______________________________________ :_______________________________________

iii) Address of parent / guardian

:_______________________________________ _______________________________________

v) Telephone Number 9. Occupation of the parent (with office address)

:______________________________________ :______________________________________ _______________________________________

10. Choice of Programme (Put a mark in the appropriate box) 11. Academic Performance:

M.E. (CSE)

M.E (Manufacturing)

MCA

MBA

A. X std and HSC / Diploma: Sl.No. Name of the Institution with address 01 02 B. GATE / TANCET Details: Exam Name

% of Marks

Year of Passing

Exam Year

Score

C. Qualifying Degree: Sl.No. Degree 01. 02. 03.

College

University

Class with % of marks / Grade

DECLARATION All the information furnished above is true to the best of my knowledge. I am aware that any wrong information of suppression of information may result in punitive action in addition to the cancellation of my candidature for admission. Date: Place: Signature LIST OF DOCUMENTS TO BE PRODUCED AT THE TIME OF ADMISSION 1. 2. 3. 4. 5. 6. 7. 8. Admission Allotment order for G.Q.only Acknowledgement letter for G.Q.only Transfer and conduct certificate(s) Community Certificate SSLC, HSC, Degree or equivalent Mark statement & Degree Certificate Entrance Examination Hall Ticket and Mark Sheet Physical Fitness Certificate Passport size photo 3 copies