Application Form - Christian College of Engineering and

ACKNOWLEDGMENT
Form No:
CHRISTIAN COLLEGE OF
ENGINEERING & TECHNOLOGY
BHILAI
Name of the Student :
Name of the Father :
Place :
www.ccetbhilai.ac.in
Date :
Admission In-Charge
ESTABLISHED IN
1998
FOLLOWING DOCUMENTS ARE TO BE SUBMITTED WITH THIS FORM
(4) Caste Certificate
(1) 10th
(2) 12th
(3) PET/JEE Score Card
(5) Domicile
(6) Address Proof
(7) Concern Letter from Church (for Christian students only)
(8) Diploma Marksheet (B.E. III Sem Lateral Entry)
(9) B.E. 1st to 8th Semester Marksheet (M.Tech.)
UNDER THE AEGIS OF ST. THOMAS MALANKARA ORTHODOX SYRIAN CHURCH MISSION, BHILAI
DOCUMENTS REQUIRED WHILE COMPLETING THE ADMISSION PROCEDURE IN THE COLLEGE
1. Transfer Certificate
(Original)
2. Conduct Certificate
(Original)
3. Migration Certificate
(Original)
4. X Marksheet
(4 Photocopies)
5. XII Marksheet
(4 Photocopies)
6. P.E.T Marksheet
(4 Photocopies)
(Through CGPET Counseling Students)
7. P.E.T. Allotment Slip
Student (4) Father (1)
8. Passport Size Photograph
9. Income Certificate
10. Affidavit
(Photocopy of the Payment Slip)
(If There Is Gap During Study Period)
CHRISTIAN COLLEGE OF ENGINEERING & TECHNOLOGY
Kailash Nagar, Near Industrial Estate, Bhilai, Distt: Durg, C.G., Pin-490026,
Tele. : 0788 - 2286662/3/4, Fax: 0788 - 2285266, E-mail: ccet@ccetbhilai.ac.in. Web: www.ccetbhilai.ac.in
APPROVED & ACREDITTED BY AICTE, AFFILIATED TO CHHATTISGARH SWAMI VIVEKANAND TECHNICAL UNIVERSITY, BHILAI
APPLICATION FORM
FORMAT FOR AFFIDAVIT BY THE STUDENT
TO BE PREPARED ON A NON-JUDICIAL STAMP PAPER OF RS 50
1)…………………………………………………………………………….(full name of student with admission/registration/ enrolment
YOUR CHOICE OF TODAY WILL DEVELOP
THE STRENGTH YOU NEED FOR TOMORROW
number) S/o/D/oMr./Mrs. ………………………………….Having been admitted to Christian College of Engineering & Technology, have carefully
read and understood the provisions contained in Writ Petition No. (C) 656/1998 of Supreme Court of India on curbing the Menace of Ragging in Higher
Educational Institutions.
2) I am aware as to what constitutes ragging
3) I am fully aware of the penal and administrative action that is liable to be taken against me in case I am found guilty or abetting ragging, actively or passively,
or being part of a conspiracy to promote ragging.
4) I hereby solemnly affirm and undertake that:a) I will not indulge in any behavior or act that must constitute ragging.
b) I will not participate in or abet or propagate through any act of commission or omission that may be constituted as ragging.
5) I hereby affirm that, if found guilty of ragging, I am liable for punishment without prejudice to any other criminal action that may be taken against me under
any penal law or any law for the time being in force.
6) I hereby declare that I have not been expelled or debarred from admission in any institution in the country on account of being found guilty of abetting of being
part of a conspiracy to promote ragging and further affirm that in case the declaration is found to be untrue, I am aware that my admission is liable to be
cancelled.
Declared this ……………. Day of ………………… month of …………………… year.
Signature of Student
FORMAT FOR AFFIDAVIT BY PARENT/GUARDIAN
TO BE PREPARED ON A NON-JUDICIAL STAMP PAPER OF RS 50
1) Mr./Mrs./ Ms………………………………. (full name of parent/guardian) father/mother of ………………………………… (full name of
student with admission/registration/ enrolment number), having been admitted to Christian College of Engineering & Technology, have carefully read and
understood the provisions contained in Writ Petition No. (C) 656/1998 of Supreme Court of India on curbing the Menace of Ragging in Higher Educational
Institutions.
2) I am aware as to what constitutes ragging
3) I am fully aware of the penal and administrative action that is liable to be taken against me in case I am found guilty or abetting ragging, actively or passively,
or being part of a conspiracy to promote ragging.
4) I hereby solemnly affirm and undertake that:a) My ward will not indulge in any behavior or act that must constitute ragging.
b) My ward will not participate in or abet or propagate through any act of commission or omission that may be constituted as ragging.
5) I hereby affirm that, if found guilty of ragging, my ward will be liable for punishment without prejudice to any other criminal action that may be taken against
me under any penal law or any law for the time being in force.
6) I hereby declare that my ward has not been expelled or debarred from admission in any institution in the country on account of being found guilty of abetting of
being part of a conspiracy to promote ragging and further affirm that in case the declaration is found to be untrue, I am aware that my ward's admission is
liable to be cancelled.
Declared this ……………. Day of ………………… month of …………………… year.
Signature of Parent/ Guardian
APPLICATION FORM
FOR OFFICE USE ONLY
Form No:
For 1st YEAR BACHELORS PROGRAMME IN ENGINEERING/B.E Third Sem Lateral Entry/M.E/M.Tech Course
CHECK LIST
This form should be duly filled in with all supporting documents, attested by a GAZETTED Officer
and returned to the College Office on or before 5th June, 2015
Please note that :
a) Form should be completely filled for the details asked.
b) Admission will be purely based on merit, hence submission of this form does not guarantee admission.
c) This application form is not transferable, hence cannot be used by another candidate.
d) To be filled by the Candidate.
1. Transfer Certificate
2. Conduct Certificate
Affix a Stamp Size
Parents Photograph
3. Migration Certificate
4. X Marksheet
Affix a Stamp Size
Student Photograph
5. XII Marksheet
6. P.E.T/JEE Scorecard
(Signature of Candidate)
STUDENT INFORMATION
7. P.E.T. Allotment Slip
Name
8. Domicile Certificate
9. Caste Certificate
(Fill in Capital only)
(First Name)
Date of Birth
/
Caste
Gen
(Middle Name)
/
SC
Gender
(DD/MM/YYYY)
ST
OBC
Native Place
11. Concern Letter from Church
Mother Tongue
Nationality
12. Passport Size Photograph
Address
13. Income Certificate
Tel (R)
14. Affidavit
E-mail
Hostel Facility Required
Name
Mother’s Name
Relation
Mother’s Occupation
Occupation
Father’s Occupation
responsibility of submitting the following documents (Sl.No. ................................................) which I have not submitted
during admission before ....................................... In case of my failure I will have no claim on the college if my
Service
Annual Income
Govt.
Govt.
Public
(Parent Signature)
Mobile No. :
Mobile No. :
Business
Agriculture
Public
Private
Organization Name
Organization Name
Tel. [R]
Affix
Passport
Photograph
Private
Department
Designation
Designation
Local Address
Address
(Student Signature)
No
Sector
Agriculture
Sector
Department
admission is cancelled by the CSVTU/DTE.
Business
Yes
LOCAL GUARDIAN INFORMATION
Father’s Name
Service
TG
Mobile
PARENT INFORMATION
Ms/Mr ............................................................... S/o, D/o ............................................................... undertake the
Female
Blood Group
Place of Birth
UNDERTAKING
Male
OTHERS
10. Address Proof
(Verified By)
(Last Name)
Tel. [R]
Mobile
(Parent Signature)
Mobile
(Gaurdian Signature)
FEED BACK OF ENGINEERING ASPIRANTS 2015 -16
Please rank these branches in order of your preference:
U. G. Course:
1.Name of the student
P. G. Course:
Electrical
Computer Science
M. Tech CAD/CAM Robotics
Mechanical
Information Technology
M. Tech Nanotechnology
Electronics & Telecommunication
Particulars of Qualifying Examinations:
B.E.
Please attach copies of certificates of examinations passed.
Exam Passed
Board
Name of School
Place & State
Total Marks
Marks Obtained
Class XII
JEE
CGPET
Through Church
College Website
Newspaper Media
Hoardings
Alumini
Electronic Media
Friend / Colleagues
) tick mark one or more
Because it is a reputed college
Because the infrastructure and the living conditions are good
Because the free structure is less
Because there is no capitation fee
Because it is a Christian Institute
Because hostels (Boys/Girls) are inside the college campus
5. Are college officials cordial & helpful?
Yes
No
6. It the communication methods of the college strong & reliable?
Yes
No
7.Is the hospitality good?
Yes
No
8.If you do not get branch of your choice, will you take admission in this Institute?
Yes
No
9.Would you recommend this college for admission?
Yes
No
10.Any other comment that you may have
Particulars of Qualifying Examinations:
B.E. II Year Lateral Entry
Please attach copies of certificates of examinations passed.
Exam Passed
3.How did you about the college?
4.Why did you select this College? (
Class X
Board/
University
2.Father's Name
Signature of the candidate
2015 -2016 म इं जीिनय रं ग म वेश के इ छु क छा /छा ा
Name of School
/College
Place & State
Total Marks
क
ित या
Marks Obtained
1.छा / छा ा का नाम
2.िपता का नाम
Class X
3.आपको इस कॉलेज क जानकारी कै से िमली
Diploma
Particulars of Qualifying Examinations:
M. E. / M. Tech.
Please attach copies of certificates of examinations passed.
Exam Passed
Class X
Class XII
B.E.
(1st to 8th sem)
Board/
University
Name of School
/College
Place & State
Total Marks
चच ारा
सं था वेबसाइट ारा
अखबार ारा
हो डग ारा
भूतपूव छा / छा ा ारा
टी. वी.
4.आप इस कॉलेज को य चुने ? िचि हत कर (
Marks Obtained
दो त
ारा
ारा
)
य क यह एक नामी कॉलेज ह।ै
य क यहाँ का वातावरण सुखद और
व था मजबूत ह।ै
य क यहाँ का िश ा शु क कम ह।ै
य क यहाँ कोई डोनेशन नह लगता।
य क यह एक ईसाई सं था ह।ै
य क कपस के भीतर छा ावास क सुिवधा ह।ै
5. या सं था के अिधकारी िमलनसार और सहायक ह।
हाँ
नह
6. या सं था का दरूसंचार मा यम अ छा ह।ै
हाँ
नह
7. या सं था का वागत
हाँ
नह
8. या आपको मनचाहा ांच नह िमलने पर कोई दस
ू रा ांच इस स था म लेना पसंद करगे ?
हाँ
नह
9. या आप इस सं था का चार करगे।
हाँ
नह
(अगर हाँ तो उन
व था सराहनीय ह।ै हाँ नह
ि य का ई-मेल या फ़ोन नं)
GATE Exam
10.अ य कोई राय / सुझाव
छा /छा ा के ह ता र