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: [email protected]. 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
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