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Application Form For Lateral Entry

This document contains an application form for admission to a lateral entry B.Tech program. It requests information such as the applicant's name, father's name, date of birth, contact details, category, educational qualifications, and details of a draft payment. It provides instructions that a written test will be held for math, physics, chemistry, and English. Candidates must bring photos, certificates, and caste or income documents. The last date for submitting the application form is listed as well as the date when the list of selected candidates will be posted online.

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Neepur Garg
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69 views1 page

Application Form For Lateral Entry

This document contains an application form for admission to a lateral entry B.Tech program. It requests information such as the applicant's name, father's name, date of birth, contact details, category, educational qualifications, and details of a draft payment. It provides instructions that a written test will be held for math, physics, chemistry, and English. Candidates must bring photos, certificates, and caste or income documents. The last date for submitting the application form is listed as well as the date when the list of selected candidates will be posted online.

Uploaded by

Neepur Garg
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Sl.No.

Examination Board/University Subjects % of Marks


1. 10th/Equivalant
2. 10+2 Exam.
3. B.Sc.
4. Diploma in_______



Phone: +91 5414 228409, 225504 Fax: 05414 225509 e-mail : [email protected], Website: http:/ / iict.ac.in
1. Name of the Applicant :
2. Name of Father/Guardian:
3. Date of Birth :
4. Contact No :
5. E Mail Id : ...........................................................................................................................................
6. Full Address (for correspondence)


PIN
7. Category : Please tick Gen OBC SC ST PH

8. Educational Qualification: (attach qualifying exam. Certificate & Marksheet)
9. Applied Under: Please tick B.Sc. Diploma
10. Draft Details :
Date: ..........................
Place: ......................... Sign of Candidate
Affiliated to UPTU Lucknow & Approved By AICTE, MHRD, (GOI)
Chauri Road, S.R.N. BHADOHI-221401(U.P.)
General Instructions:
Under the aegis of the Development Commissioner (HC), Ministry of Textiles Govt. of India
DD No Amount Bank
Affix
Self Attested
Passport Size
Recent
Photograph
D M Y D M Y Y Y
D M Y D M Y Y Y
Admission Form
Lateral Entry to B. Tech. II Year
1. The written test will comprise of Maths, Physics, Chemistry & English of XII Standard. 2. Bring latest 6 color passport size photos.
3. Fees for Hosteler is 85,775/- and for non Hostler is 53,050/- . 4. A draft of Rs. 500/ - for SC/ ST, girls , PwD & Rs. 1000/ -
for Gen. & Other in favour of Director, IICT, payable at Bhadohi, must be attached with the application form. 5. H. S. Certificate,
mark sheet, certificate of qualifying exam, caste certificate issued by competent authority, income certificate, medical fitness certificate,
affidavit for any break in education should be brought during test.
Last Date of Submitting Application Form : 11 August 2014
List of Selected Candidates will be uploaded in the institutes Website on : 13 August 2014

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