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Indian Institute of Technology Guwahati

The document appears to be an application form for admission to postgraduate programs at the Indian Institute of Technology Guwahati, which requests basic personal information from applicants such as name, date of birth, contact details, educational history, professional qualifications and experience, publications, and a reference letter. The reference letter section provides a format for referees to comment on the applicant's strengths, limitations, English proficiency, and overall recommendation for the proposed study.

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Hanniel Madramootoo
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40 views3 pages

Indian Institute of Technology Guwahati

The document appears to be an application form for admission to postgraduate programs at the Indian Institute of Technology Guwahati, which requests basic personal information from applicants such as name, date of birth, contact details, educational history, professional qualifications and experience, publications, and a reference letter. The reference letter section provides a format for referees to comment on the applicant's strengths, limitations, English proficiency, and overall recommendation for the proposed study.

Uploaded by

Hanniel Madramootoo
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Indian Institute of Technology Guwahati

Application Form for Admission to MTech/MDes/PhD Programme for FOR IG! APP"I#A!T$
For Department/Centres use: Reg. No.F/ Affix passport size Photograph

1.(a) Name: Mr/Ms/Mrs............................................................. (b) Father/Husband/Guardian ........................................................................... (c) Addresses: i) For correspondence ................................................................................... ................................................................................... .................................................................................. Email: !&) Nationalit%: ............................. Phone: ii) Permanent

........................................................................... ........................................................................... ........................................................................... Fax: !d) Passport No. $$$$$$$$$$$$.. !attach photocop% o" Passport)

. !a) Date o" #irth : date $$ month $$$.%ear$$.. !&) 'arital (tatus:$$$.................................

). !a) Department/Centre $$$$$$$$$$$$$$$$$$... !&) Programme !PhD) :

to

*hich

the

candidate

see+s

admission:

!c) ,ndicate research areas "or PhD in order o" pre"erence : !as gi-en in the ad-ertisement) : !i) !ii) !iii) .. Details o" /ni-ersities/,nstitutions attended !"rom 0 th standard on*ards) !attested copies o" certi"icates and mar+sheets/grade cards must &e attached)
"e%el of e&amination !ame of degree or certificate 'oard/ (ni%ersity #ountry Duration of programme )ear of passing * Mar+s/ #GPA/ #PI ,,

E1ui-alent to 023 le-el exam o" C#(E or ,C(E4 ,ndia5 6raduate !#achelors) le-el Post7graduate !'asters) le-el 8ther
* e.g. General Certificate Education (GCE) Examination (London/Cambridge/Sri Lanka) at the Advanced (A) level or !igh School Certificate Examination of the Cambridge "niver#it$ etc. ** %ention the grading #cale al#o (e.g. &.' out of (.) etc.) if mark# are not a*arded

9. a) Pro"essional :uali"%ing Examination passed !attested cop% o" certi"icate must &e attached): !0) 6A;E555 ! ) /6C/C(,R NE;/8thers555 (u&<ect (cor All =alid (u&<ect Date o" =alid up e ,ndia up to :uali"%in to Ran+ g 555 Applica&le4 i" the candidate *as resident in ,ndia and appeared in such examinations &) (core o" other such examination e.g. 6RE >. a) 'edium o" instruction at /ndergraduate/6raduate le-el: &) ?no*ledge o" English: !," medium o" instruction *as not English4 suita&le proo" a&out the pro"icienc% in English should &e su&mitted) @. a) Pro"essional Experience !;eaching/ Research/ ,ndustrial) i" an% !proo" to &e attached). Name o" organisation !i) !ii) !iii) !&) Aist o" pu&lications/pro<ects i" an%: !Attach a separate sheet *ith details4 i" re1uired) Position held ;%pe o" *or+ Period

@.

Aist o" Enclosures :

B.

Re"eree !Name and address) : !Please send a letter o" re"erence in a sealed en-elope "rom the Cead o" Department or a Pro"essor o" the ,nstitute//ni-ersit% %ou last studied) Name: Designation/Position: Address:

Declaration
, here&% declare that the entries made in this application "orm are correct to the &est o" m% +no*ledge and &elie". ," selected "or admission4 , promise to a&ide &% the rules and regulations o" the ,nstitute. , note that the decision o" the ,nstitute is "inal in regard to selection "or admission and assignment to a particular department and "ield o" stud%. ;he ,nstitute shall ha-e the right to ta+e an% action it deems "it4 including expulsion4 against me at an% time a"ter m% admission4 i" it is "ound that an% in"ormation "urnished &% me is incorrect. Place: Date: (ignature o" the applicant

(To the Referee n addition to res!ondin" to the items be#o$% !#ease comment s!ecifica##& on the a!!#icant's stren"th and #imitationsfor the !ro!osed stud& and a#so !roficienc& in (n"#ish. )#ease use the bac*side of this form or attach a #etter. The referee is re+uested to !ut this form in a sea#ed en,e#o!e and si"n across the sea# before handin" it o,er to the candidate.)

" TT R OF R F R !#
For admission of foreign students in Indian Institute of Technology Guwahati- Guwahati- India

ha,e *no$n Mr. /Ms./Mrs. --------------------------------% $ho intends to a!!#& for the )h. !ro"ramme in ndian nstitute of Techno#o"& Gu$ahati% for ---- &ears. ha,e *no$n the a!!#icant in m& ca!acit& as ( please tick where applicable): instructor in one or more courses em!#o&er su!er,isor other: !#ease e/!#ain

The candidate ran*ed a!!ro/imate#& ------- in a c#ass of about ------ students. The fo##o$in" are m& ratin"s on his +ua#ities (please tick):
0ua#it& 2ac*"round !re!aration 1na#&tica# abi#it& )otentia# research abi#it& Moti,ation .i#i"ence 5ra# 6ommunication 7ritten 6ommunication 5,era## e,a#uation (/ce##ent Good 1bo,e a,era"e 1,era"e 2e#o$ 3nab#e to a,era"e 4ud"e

For the !ro!osed stud&% (rror: Reference source not found (please tick where appropriate) hi"h#& recommend recommend $ith some reser,ation the candidate. recommend do not recommend

8i"nature of the Referee: Name of the Referee: 1ddress: Te#e!hone No. Fa/ No.

.ate : )osition/.esi"nation:

e9mai# address

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