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Amet university
1. Cost of Application
Form: Rs.1000/-
Cost of Application
Form: Rs.1000/-
Photo with
Sky Blue Background
Application No.
APPLICATION FOR ADMISSIONS 2012 - 13APPLICATION FOR ADMISSIONS 2012 - 13
Roll No.
(To be allotted by the University)
1.Name of the Applicant
DD No & Date:
Bank Name:
3.Date of Birth
5.Blood Group
Male Female
6.(a) Religion:
6.(b) Social Status OBC/SC/ST/Others
4.Gender
8.Name of the Father / Guardian
11.Mother’s Name
9.Occupation of Father / Guardian 10.Father’s / Guardian’s Annual Income
12.Permanent Address (Do not repeat the Name)
7.Nationality
2.Course Applied for: Refer the Appendix for course detailsRefer the Appendix for course details
st
1 Option
nd
2
rd
3
Name of the Course Code
DD
CASH
(Put a mark)a
Fill the details in English in block letters
Read carefully the Instructions given in theAppendix
Use black ball point pen for filling the details
For Eligibility Criteria, please visit our website
www.ametuniv.ac.in
1
GME / POST GRADUATE COURSESGME / POST GRADUATE COURSES
13.Address for Correspondence (Do not repeat the Name)
Option
Option
(Under Sec. 3 of UGC Act 1956)
2. 14.STD Code 15.Telephone 16.Mobile Number
18.Email ID ................................................................................................................................
17.Local Guardian (Name/Address/Local Phone Number)
20.For GME/MBA/M.Sc/M.Tech., Course only
Marks Scored in English (Higher Secondary/12th Std) .....................
College University Year of passing Percentage / CGPA*
*CGPA: Cumulative Grade Point Average
Specialisation in UG Course (In Block Letters)
19.For MBA Course only
Name of the Test CAT / MAT / ATMA / XAT / JMET / TANCET Month & Year Test Score
%
Certificate of Competency
MATE (FG)
MASTER (FG)
EXTRA MASTER
SECOND CLASS (MOTOR)
FIRST CLASS (MOTOR)
EXTRA CHIEF
MICS
% of Marks in
Major Subject
Academic
Qualification
S.No Name of the Organisation Position
Period of service
From To
Major
P.U.C. / + 2
Bachelor’s Degree (Attested
Xerox copy of Provisional
Certificate or Degree/Diploma
to be enclosed)
For MARINERS Category of
Eligibility
Issuing
Authority
Date
of Issue
Place
of Issue
Certificate
Number
ClassYear of
Passing
University
Name of the
Institution
21. P.G. COURSES FOR MARINERS (CODE NUMBERS: 402 and 403 ONLY)21. P.G. COURSES FOR MARINERS (CODE NUMBERS: 402 and 403 ONLY)
CDC
P.G. COURSES FOR MARINERS / OTHERS (MBA., M.Sc., M.Tech.,)P.G. COURSES FOR MARINERS / OTHERS (MBA., M.Sc., M.Tech.,)
22. Professional Experience22. Professional Experience
2
3. 26.Please answer the following questions.
a) How did you come to know about AMET University?
b) Are you aware of the fee structure?
News Paper
Yes No
TV Website Edu. Fair Alumni Others
If others specify:
DeclarationDeclaration
Send filled in Application to City Office (Anna Nagar) Address
23.Whether Hostel required
25.Specify Entrance Examination Centre (Refer Appendix)
24.Sports Achievement
State National International NoneYES NO
I confirm to the best of my knowledge that the information given in this form is correct. If admitted to this course, I, also agree to
abide by the rules and regulations of AMET University. I do agree to abide by the University Anti Ragging Regulations, as
directed by the Hon'ble Supreme Court of India. Please see number 5 of instructions below.
Applicant's Signature Father’s / Mother’s/ Guardian's Signature
Date ……...........
INSTRUCTIONS:
1. Enclose the attested copies of the following along with the application form
th th
(i) 10 & 12 std mark sheet
(ii). Provisional / Degree Certificate
(Iii) Consolidated Mark Sheet Statement
(iv) Sports Merit Certificates, if any
(v) Transfer Certificate
(vi) Conduct Certificate from last School/college attended
(vii)Community Certificate
2. Paste Passport size colour photograph on page 1 (applications without photograph will be rejected)
3. All the original certificates to be submitted at the time of admission for verification
4. Maintain a photocopy of this application and bring copy at the time of admission.
5. Affidavit by the parent/student in Non-Judicial stamp paper as per your state rules as given in the specimen copy will
have to be submitted at the time of admission. (Specimen available in Information Booklet)
6. Affidavit for Indemnity Bond by the student in Non-Judicial stamp as per your state rules as given in the specimen copy
will have to be submitted at the time of admission. (Specimen available in Information Booklet)
7. Upper portion of the Hall Ticket should be attached with the Application.
3
(Dispute , if any, will be subject to Chennai jurisdiction only)
……………………….............. ………………………..........................................................
4. nd
No.5107, H2, 2 Avenue, Anna Nagar, Chennai 600 040
Tel. 044 -26161026/1180/2031 Fax: 044 - 26162827
CITY OFFICECITY OFFICE
No.135, East Coast Road, Kanathur 603 112, Chennai, India
Tel. 044 - 32577002/32577030/27472155/57 Fax: 044 - 2747 2804
Mob: 9381505747 / 9345656224 Mob: 9382350607
CAMPUSCAMPUS
1. Use Separate form for Under Graduate/HND Courses
2. For Post Diploma and Research Programmes (M.Phil.,/Ph.D) Separate Application Forms can be downloaded from
www.ametuniv.ac.in
3
Medical Examination
Selected for admission
Fit
Yes No
Unfit
NOTE:
For Office Use onlyFor Office Use only
Application Received on Verified by
Interviewed on
Results of Entrance
Examination
Results of Interview
Score
Well Suitable Suitable To meet counselor
Pass Fail
Web: www.ametuniv.ac.in/ Email:office@ametuniv.ac.inWeb: www.ametuniv.ac.in/ Email:office@ametuniv.ac.in
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5. Code No. Name of the course Duration
103 GME Pre Sea Training for Graduate Mechanical Engineers 1 year
302 MBA Shipping & Logistics Management 2 years - 4 semesters
303 MBA Shipping Finance 2 years - 4 semesters
304 MBA Marine Human Resource Management 2 years - 4 semesters
305 MBA Cruise Ship Hospitality Management 2 years - 4 semesters
401 M.Sc. Marine Biotechnology 2 years - 4 semesters
402 M.Sc. Fleet Operations Management 2 years - 4 semesters
403 M.Tech Marine Engineering Management 2 years - 4 semesters
Appendix
5
EXAMINATION CENTRE DETAILS
1. DELHI
2.MUMBAI
3. LUCKNOW
4. PATNA
5. COCHIN
6. KOZHICODE
7. CHENNAI
COURSE DETAILS WITH CODE NUMBER:
6. HALL TICKET
FULL NAME AND COMPLETE POSTAL ADDRESS OF THE CANDIDATE (IN CAPITAL LETTERS)
Pin Code
Name ............................................................................................
Address
SIGNATURE OF THE CANDIDATE
Course Name
Course Code
Examination Centre
Mobile Number
APCAUMEPLITIONNBR
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FULL NAME AND COMPLETE POSTAL ADDRESS OF THE CANDIDATE (IN CAPITAL LETTERS)
Pin Code
Name ............................................................................................
Address
SIGNATURE OF THE CANDIDATE
Course Name
Course Code
Examination Centre
Mobile Number
APPLICATIONNUMBER
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[REFER APPENDIX FOR COURSE AND EXAMINATION CENTRE DETAILS]
[ATTACH THIS PORTION TO APPLICATION]
DETACH THIS PORTION OF THE HALL TICKET AND PRODUCE DURING ENTRANCE EXAMINATION