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Phone No.: 0731-2582 111/ 112/ 121/ 125; Email:director@sgsits.ac.in, Website:sgsits.ac.in No.: Admin-FN/PIO/GC/2015/PR-01 Date: 26/05/2015 Admission for Foreign National (FN)/ Person of Indian Origin (PIO)/ Gulf Countries Worker s Quota (GCWQ), in B.E. (Session 2015-16) Applications on prescribed proforma are invited from the eligible candidates for B.E. 4YDC program under the above mentioned quota. The application forms can be obtained from the office of the undersigned on payment of Rs. 5,000/- or may be downloaded from the website of the Institute (a demand draft of Rs. 5,000/- is required to be paid along with downloaded form, in favour of Director, SGSITS, Indore payable at Indore). The duly-filled application form may be submitted to the office of the undersigned up to 5:00 PM till June 25 th, 2015. The counseling shall be held on June 30 th, 2015, at 12:00noon, in the office of the undersigned. Any changes in the counseling dates if any shall be informed on the website. The admission to all quota mentioned above shall be as per the definitions and prevailing rules specified by the Ministry of Human Resource Development & Foreign Affairs, AICTE, New Delhi & DTE, Bhopal. DIRECTOR To be published in 1. Dainik Bhaskar All MP Edition 2. Times of India 3. Rojgar & Nirman

Rs. 5,000/- Or equivalent in US $ FORM NO. SHRI G. S. INSTITUTE OF TECH. & SC., INDORE (M.P.) (An Autonomous Institution, Established in 1952) 23, Park Road, Indore - 452 003 (M.P.) INDIA Affiliated to Rajiv Gandhi Proudyogiki Vishwavidyalaya, Bhopal Tel. No. : 2544415, 2582111,2582121, 2582125 Fax No. 0731-2432540; Web Site : www.sgsits.ac.in or www. Sgsitsindore.in email : director@sgsits.ac.in APPLICATION FORM FOR PERSON OF INDIAN ORIGIN/FOREIGN NATIONALS /CHILDREN OF INDIAN WORKERS SERVING IN GULF COUNTRIES. FOR ADMISSION TO FIRST YEAR B.E. COURSES (SESSION 2015-2016) AFFIX SELF SIGNED PASSPORT SIZE LATEST COURSE FOR WHICH APPLIED: ( B.E.) YOUR CHOICE OF BRANCHES OF B.E.COURSE IN THE ORDER OF PREFERENCE (Elex. & T.C. Engg./ Elex. & Instru. Engg./ Comp. Sc. & Engg./ Ind. Prodn. Engg.) PHOTOGRAPH (1) (3) (2) (4) 1. DETAILS OF CANDIDATE: (A) Name (IN BLOCK LETTERS) (B) Address for Correspondence (C) Date of Birth City State Country: Pincode Phone No. E-mail : Date Month Year (D) Passport No. of candidate (if available) (E) Issuing Authority F) Merit Marks in Physics, Chemistry, Marks (PCM) out of Mathematics of 12th class of 10+2 Marks (PCM) % system of M. P. Board or equivalent Examination (for 4 year B.E. Course.) 2. DETAILS OF QUALIFYING EXAMINATION (A) Name of Examination (B) Year of Passing (C) Aggregate Marks (%) (D) Board/University (E) Proof of Equivalence

2 3. SPECIFY, IF ANY HIGHER EXAMINATION IS PASSED (A) Name of Examination (B) Year of Passing (C) Aggregate Marks (%) (D) Board/University 4. Are you a PIO/FOREIGN NATIONAL/GULF COUNTRY candidate? PIO/FN/GCW (Strike out whichever is not applicable) 5. If you are a GULF COUNTRY candidate, enclose a certificate from concerned Indian Diplomatic Mission (Embassy)/Chancellery/Commission to the effect that your Father/Mother is serving in that country as worker such as Meson, Carpenter, Nurses or any job not above this level. Give certificate of employment of mother/father: (A) Country in which mother/father working (B) Issuing Authority of passport (C) Date & Number (D) Organization (where working) (E) Date of expiry of work permit 6. If you are a PIO candidate, then give the details of the person, who held Indian Passport. (Candidate/Parent/ (Strike out whichever is not applicable) (A) Name of Person (B) Passport No. (C) Date of Issue (D) Issuing Authority (E) Country 7. If you are a FOREIGN NATIONALS candidate, give details: (A) Name (B) Passport no. (C) Issuing Authority (D) Nationality/Citizenship (E) Country 8. Details of Father (A) Name (B) Occupation (C) Passport No. (D) Issuing Authority 9. Details of Mother (A) Name (B) Occupation (C) Passport No. (D) Issuing Authority

10. Permanent Address of Parent 11. Present Address of Parent City State Country Pincode Phone No. Fax No. Email City State Country Pincode Phone No. Fax No. Email 12. Details of the Demand Draft in case the application form has been downloaded. (A) Demand Draft No. (B) Date of Issue (C) Issuing Bank (D) Amount (Rs. 5000/- or Equivalent in US $ in favour of Director, SGSITS payable at Indore.) 13. DECLARATION BY THE CANDIDATE I, solemnly declare that the above information is correct and I know that my admission is liable to be cancelled, if any of the above information, is found incorrect. I agree to provide all the additional information and certificates required for the consideration of my application. I undertake to abide by the rules and regulation of the Institute during the period of study, if I am admitted to the course. Date : Place: (Signature of Candidate) (Signature of Parent)

4 INSTRUCTIONS FOR PIO/FOREIGN NATIONALS/GCW CANDIDATES I. Seats reserved for PIO/ FN/ GCW candidates in Shri G.S. Institute of Technology and Science, Indore are as under: Bachelor of Engineering (B.E.) 4YDC Course Sr. No. Branch No. of Seats 1. Computer Science & Engineering 14 2. Electronics & Telecommunication Engineering 14 3. Electronics & Instrumentation Engineering 9 4. Industrial & Production Engineering 4 II. DEFINITIONS : (A) Persons of Indian Origin (PIO) : Persons who are citizens of other Countries (except Pakistan & Bangladesh) who at any time held an Indian Passport, or who or either of his parents or any of his grandparents was a citizen of India by virtue of the provisions of the Constitution of India or Sec 2(b) of Citizenship Act, 1955(Act No. 57 of 1955). (B) Foreign Nationals (FN) : Citizens of all Countries other than India, who are not of Indian origin as defined under PIO. (C) Gulf Country Candidate (GCW ) : Children of Indian workers serving in the gulf countries. III. BASIC ELIGIBILITY CRITERIA: The candidates shall be considered for admission to First Year B.E. course (4YDC) against PIO/Foreign Nationals/ GCWQ seats who have who have passed the qualifying examination (i.e. Class 12 th of 10+2 System) or equivalent examination with Physics, Chemistry & Mathematics subjects. IV. The application in prescribed proforma must be sent to the Institute alongwith: (A) Mark sheets of 12 th class of 10+2 system of Board of Secondary Education Madhya Pradesh or equivalent examination from recognized institution. (B) A certificate proving PIO (Persons of Indian Origin) /FN (Foreign National)/GCWQ status. (C) A certificate from competent authority of the organisation, where working. V. The completed application in prescribed proforma must reach the office of The Director, Shri G S Institute of Technology & Science, Indore, 23, Park Road, Indore on or before 5:00 PM on 25/06/2015. VI. VII. The admission will be made on merit basis for which the counseling will be held on 30/06/2015 at 12.00 Noon in the Institute. The candidate shall be required to report to the Institute along with his/her Father or Mother or Local Guardian to the Institute to complete formalities of admission on the date specified i.e. on 30/06/2014. If father and mother both are not alive, then the signature of the Guardian shall be allowed and admitted on the declarations, provided proper certificate of Guardianship is produced.

VIII. IX. 5 The candidates shall be required to deposit the fee of US $ 3000/- per year plus Caution Money of US $ 1500 (refundable) payable once, plus all other fee and guarantees as per rules as a pre-requisite for admission. The Candidate is therefore required to bring certified Bank- References for paying capacity. The provision of Transfer from one Institute to other Institute in M.P. shall not be applicable. X. The hostel-accommodation shall be available as per Institute rules applicable in such cases. XI. Photocopies of all relevant documents must be attached as per LIST -1. XII. The candidate is required to bring certificate of annual income of Father/Mother/Guardian. XIII. XIV. XV. The candidate must submit School/College Leaving Certificate (Transfer Certificate) & Migration Certificate in original at the time of admission or within seven days of his admission. The candidate must attend all the classes regularly. If he remains absent continuously from the classes for more than fifteen days, his admission is liable to be cancelled. For any dispute in connection with your admission, the interpretation given by the Director of the Institute shall be final. The jurisdiction of the Court of Law at Indore shall be binding for judicial review in all matters related to it or arising out of it. DIRECTOR