UNIVERSITY COLLEGE OF ENGINEERING, KOTA (FORMERLY ENGINEERING COLLEGE, KOTA) RAJASTHAN TECHNICAL UNIVERSITY, KOTA RAWATBHATA ROAD, AKELGARH, KOTA-324010
website:www.rtu.ac.in Telefax:0744‐2473035,2473920
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CHECK LIST OF COLLEGE FEES AND DOCUMENTS FOLLOWING DOCUMENT REQUIRED FOR ADMISSION IN I B TECH 2014-15 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
10 TH CERTIFICATE(ORIGINAL + 01 PHOTOCOPY) 12TH MARKSHEET(ORIGINAL + 01 PHOTOCOPY) TRANSFER CERTIFICATE FROM SCHOOL(ORIGINAL + 01 PHOTOCOPY) MIGRATION CERTIFICATE(ONLY C.B.S.E,I.S.C.E AND OTHER BOARD) (ORIGINAL + 01 PHOTOCOPY) MEDICAL CERTIFICATE(ORIGINAL) 02 PASSPORT SIZE PHOTOGRAPH JEE(MAINS) 2014 SCORE CARD(PHOTOCOPY) or RPET-2014 Score Card Photocopy ALLOTTMENT LETTER CATEGORY/CAST CERTIFICATE FOR (SC/ST/) (PHOTOCOPY) CATEGORY/CAST CERTIFICATE FOR (OBC/SBC) (ORIGINAL+PHOTOCOPY) ISSUED ON OR AFTER 01.3.2014
COLLEGE FEE: The following Fee is to be deposited alongwith admission form through Bank Challan at "Punjab National Bank, RTU, Kota" or by DD in favor of "Rajasthan Technical University, Kota." A. a. b. B. i. ii.
For Students Admitted on SFS Seats All Boys/Girls/SC/ST/OBC/SBC TFWS : Rs. 11,000 For Students Admitted on GAS Seats For SC/ST/Girls & TFWS For General/OBC Boys
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: Rs.40,000
: Rs. 12,500 : Rs. 27,500
UNIVERSITY COLLEGE OF ENGINEERING, KOTA (FORMERLY ENGINEERING COLLEGE, KOTA) RAJASTHAN TECHNICAL UNIVERSITY, KOTA RAWATBHATA ROAD, AKELGARH, KOTA-324010
website:www.rtu.ac.in Telefax:0744‐2473035,2473920 REGISTRATION FORM
Application for Registration as regular student for the session 2014-15 in the Ist Year B Tech ( I Semester Branch.____________________________________________________________________________ College Roll No. _______University Enrolment No. _____________________ B.Tech Exam Roll No. _________. Name of Student
:________________________________________________
Father's Name
:________________________________________________
Father Occupation
:________________________________________________
Official Address
:________________________________________________
Phone No
:Office___________________ Resi.___________________
Annual Income of Parent
:________________________________________________
Religion:___________________
:Cast ___________________
Whether belonging to SC/ST/OBC/SBC_________(If yes mention the cast) Sex
: (M/F)
Student Mobile No ________________________. Student email ID _______________________ Father’s/Guardian Mobile No.___________________ email ID ________________________ Fee of Rs. ________________ (Rs._________________________________) DD No._______________Date____________Bank________________Amount______________
I declare that: I have cleared the I B.Tech./II B.Tech/III B.Tech( 4 year Course) completely and I am eligible to take admission to II B.Tech./ III B.Tech./ IV B.Tech. during the session- 20 - 20 . (1) I have no dues against my name till date. (2) I have not resorted to any act of indiscipline during the previous year. (3) I have not been convicted of any criminal offence nor have I been released on bail in connection with a criminal case. (4) No case of criminal offence or moral turpitude is a pending against me in any court of Law. (5) No complaint or F.I.R. has been lodged against me by the University/Principal of constituent College/Affiliated College or by any other competent authority. Signature Date _____________________________________________________________________________ ORDER Provisionally admitted/Not admitted Proctor
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UNIVESITY COLLEGE OF ENGG.KOTA STUDENT'S PERSONAL DATA (To be filled in by the students) 1. Name ______________________________
2. College Roll No: ______________________________
3. Category __________________
4. Sex (Male/Female):__________________________
5. Date of Admission____________________
6. RPET/JEE Mains Roll No: _________________________
7. RPET/JEE Mains Marks____________________
8. RPET/JEE Mains Rank (Over all)_________Cat.Ranks______
9. Branch _____________________________ 10. Date of Birth_________________________ Village/Town_________________________
(Place of Birth)________________________________
District_______________________________________
11. Father's Name Sh.______________________________ 12. Father is Alive or Not?
ALIVE/NOT ALIVE
13.Name of Guardian & relationship Name Shri __________________________________________________________ (if father is not alive or is invalid for life) 15.Permanent Address ______________________________________________________________________________ ___________________________________________________________________Phone No__________________ 16. Address for communication
Postal
Note: All communication from this address only. Student should make arrangement for redirection if
______________________________________________ ______________________________________________
Necessary.
____________________Phone No__________________
17. Particulars about local Guardian at Kota Note: Students whose parent/guardian are not in Kota
Postal_________________________________________ ______________________________________________
are advised to adopt a local guardian at Kota, who could be contacted by the college in an emergency routine
______________________________________________
______________________________________________
Communication will not be sent at this address
____________________Phone No__________________
18. e-mail address___________________________________Mobile No.:_____________________________________ 19. Married or Single_________________________________ (If married give date of marriage & particulars of children, if any) 20. Whether belongs to SC/ST/ OBC/SBC/Ex-S/DK/PH/KM (if any give particulars) _______________________ 21. Family particulars (Father, Mother, Brother & Sister) Sr.No Name Relation
♦ Mention Designation and Name of Deptt, if in service. * Must be supported by necessary documents. 22. Particulars of academic record Class school or college Period of study
♦ Occupation
Name of University or Board
*Annual Income
Year of Passing
In case of Brother & Sister (whether married or not)
No. of attempts
Distinction & Rank if any
23. * Participation in extra-curricular activities ___________________________________________________________ 24. * Participation in N.C.C./P.T.______________________________________________________________________ 25. * Participation in Games & Sports __________________________________________________________________ 26. * Prizes & Medals won ___________________________________________________________________________ 27. * Hobbies _____________________________________________________________________________________ 28. * Whether getting any financial help in the form of scholarship, fee-concession etc. ____________________________________________________________________ Signature of student Class _________
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UNIVESITY COLLEGE OF ENGG.KOTA STUDENT'S ADDRESS SLIP (To be filled in by the students) Name of Student_________________________________ Father Name__________________________________ Class__________________Branch_______________________________________________ Contact No. of Parents/Guardians(With STD codes)________________________________ All entries will have to be made by the student in BLOCK LETTERS Address of Parents/Guardians only To, To, Name _________________________________ Name _________________________________ Fathers Name___________________________ Fathers Name___________________________ Address_______________________________ Address_______________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ ______________________Pin Code_______ ______________________Pin Code_______ Distt.____________State________________ Distt.____________State________________ Phone No._____________________ Phone No._____________________ To, To, Name _________________________________ Name _________________________________ Fathers Name___________________________ Fathers Name___________________________ Address_______________________________ Address_______________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ ______________________Pin Code_______ ______________________Pin Code_______ Distt.____________State________________ Distt.____________State________________ Phone No._____________________ Phone No._____________________
UNIVERSITY COLLEGE OF ENGINEERING, KOTA (FORMERLY ENGINEERING COLLEGE, KOTA) RAJASTHAN TECHNICAL UNIVERSITY, KOTA RAWATBHATA ROAD, AKELGARH, KOTA-324010
ALUMNI ASSOCIATION UNDERTAKING FOR LIFE MEMBERSHIP OF ECKAA I wish to become a life member of the ECKAA: I have filled the membership form I hereby give my consent to deduct Rs.500.00 (Rupees Five Hundred only) from my caution money deposited in the college and transfer this amount to ECKAA fund at the time of completion of my degree course. Permanent Address for communication:
_________________________________ _______________________________ _______________________________ Telephone No./Mobile No._____________________ E‐mail______________________________________
Name___________________ College Roll No.___________ Class______________ B Tech Branch_______________________Engg.
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Signature
UNIVERSITY COLLEGE OF ENGINEERING, KOTA (FORMERLY ENGINEERING COLLEGE, KOTA) RAJASTHAN TECHNICAL UNIVERSITY, KOTA RAWATBHATA ROAD, AKELGARH, KOTA-324010
website:www.rtu.ac.in Telefax:0744‐2473035,2473920 CHECK LIST OF COLLEGE FEES AND DOCUMENTS FOLLOWING DOCUMENT REQUIRED FOR ADMISSION IN I B TECH 2014-15 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.
10 TH CERTIFICATE(ORIGINAL + 01 PHOTOCOPY) 12TH MARKSHEET(ORIGINAL + 01 PHOTOCOPY) TRANSFER CERTIFICATE FROM SCHOOL(ORIGINAL + 01 PHOTOCOPY) MIGRATION CERTIFICATE(ONLY C.B.S.E,I.S.C.E AND OTHER BOARD) (ORIGINAL + 01 PHOTOCOPY) MEDICAL CERTIFICATE(ORIGINAL) 02 PASSPORT SIZE PHOTOGRAPH JEE(MAINS) 2014 SCORE CARD(PHOTOCOPY) or RPET-2014 Score Card Photocopy ALLOTTMENT LETTER CATEGORY/CAST CERTIFICATE FOR (SC/ST/) (PHOTOCOPY) CATEGORY/CAST CERTIFICATE FOR (OBC/SBC) (ORIGINAL+PHOTOCOPY) ISSUED ON OR AFTER 01.3.2014
SIGANTURE NAME OF CANDIDATE
UNIVERSITY COLLEGE OF ENGINEERING, KOTA (FORMERLY ENGINEERING COLLEGE, KOTA) RAJASTHAN TECHNICAL UNIVERSITY, KOTA RAWATBHATA ROAD, AKELGARH, KOTA-324010
website:www.rtu.ac.in Telefax:0744‐2473035,2473920 No._____
Dated:_________________
ADMISSION RECEIPT
Mr._________________________________S/O__________________________________ has reported for admission to I year B.Tech ______________________________________ session 2014-15 on _______________________________.
Signature of Receiver
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ENROLLMENT FORM CR NO. :‐ 13/................
BRANCH: ‐.....................................
NAME OF STUDENT: ‐............................................................................ PHOTOGRAPH
Nk= dk uke%& &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& FATHER NAME: ‐................................................................................... firk dk uke%& &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& MOTHER NAME: ‐................................................................................
ekrk dk uke%& &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& STUDENT SIGNATURE
DATE OF BIRTH:‐YY.................MM..........DD.......... AGE (ON 01.AUG.2014) :‐............ GENDER: ‐................ CATEGORY: ‐....................... TFWS/ KM/PH/EXS: ‐........................... ADDRESS:‐.......................................................................................................................... ............................................................................................................................................ STATE:‐................................. DISTRICT:‐...............................
PIN MOBILE
EMAIL ID:‐...................................................
ENTRANCE EXAM –RPET/JEE‐Mains‐‐ ROLL NO................................... MERIT.......................... Marks............ EXAM
ROLL NO
YEAR
BOARD/UNIVERSITY
OBTAINED MAX MARKS
MARKS
%
10TH
12TH
diploma
_____
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