Page No. 1 Temp. USN Full Name of Applicant in Block Letters (As per PUC Marks card): Branch FOR B.E FOR THE YEAR 'A' ADMISSION FORM KEA/CET / COMEDK Reg. No. Rank Quota Category Claimed Category Allotted First Name Middle Name Last Name/Surname/Initials Date of Birth Gender Blood Group Admission Order No. and date Issued Date Date of Allotment Last date of joining College Code Semester Admission based on Admission Type Term CET Fees Paid Religion Caste Sub-Caste Current Address City State Pincode Country Phone No. (with Code) Permanent Address City State Pincode Country Mobile No. Phone No. (with Code) Emergency Contact Number Email ID Domicile Area Place of Birth Country of Birth State of Birth Birth place Pincode Nationality NRI Mother Tongue Disability / Handicap Type of disability Economically Backward
Page No. 2 'B' ACADEMIC DETAILS PUC / 12th Details School/College Name Board Name Year of Passing Marks Card No. School/College Town School/College Country School/College State Medium of Instruction Roll/Reg. No Subject Name Maximum Marks Minimum Marks Obtained Marks ENGLISH 100 35 KANNADA 100 35 PHYSICS 100 35 MATHEMATICS 100 35 CHEMISTRY 100 35 SANSKRIT 100 35 Total 600 210 Aggregate % PCM % PCM Marks 'C' PARENTS DETAILS Father Details Name of Father If claiming under OBC/GOVT SNQ as per annual income certificate Yes Annual Income Occupation PAN Number Address City State Pincode Country Mobile No 1. Mobile No 2. Phone No.(with Code) Email ID
Page No. 3 Mother Details Name of Mother Annual Income Occupation PAN Number Address City State Pincode Country Mobile No. Mobile No 2. Phone No.(with Code) Email ID Sl.No. Documents Original Copies 1 NATA Score card for Architecture Course YES YES 2 Stamp size photos YES YES 3 10th Marks Sheet YES YES 4 12th Std. Marks Sheet/s. YES YES 5 Caster Certificate and Income Certificate (If claiming under SC/ST/1/2A/2B/3A/3B category) YES YES 6 Certificate from the indian embassy in proof of NRI status YES YES 7 KEA/COMEDK/UGCET Admin.Order 1+3 YES YES 8 Migration Certificate(if studied other than PUC of Kar.) YES YES 9 Passport and Visa Copy YES YES 10 Study Certificate 7/10 Years YES YES 11 Transfer Certificate / College Leaving Certificate YES YES
Page No. 5 DECLARATION BY THE STUDENT 1. I declare that particulars and information furnished on pages 1 & 2 are fully correct. 2. I declare that I have Passed the 10+2 Examination conducted by Gfd Board / University Gfd state during 2014 and secured 57.83% of marks in aggregate 3. If there is any false information/fake certificate or any forgery in the particulars / certificates / documents submitted by me to the authorities of MSRIT /University, my admission may at once be cancelled and necessary action may be taken. 4. I do understand that, my admission at MSRIT is provisional and subject to approval of the VTU,Belgaum. 5. I Promise to abide by the rules and regulations of the Institution and the University, and I can be subjected to disciplinary action, if need arises,and also I can be dismissed from the college, if I am found not obeying the rules and regulations 6. I agree to adhere to Rules and Regulations, Scheme of study and Examinations of the Autonomous Institute, affiliated to Visvesvaraya Technological University, Belgaum. 7. I do not indulge in ragging in any of the forms. 8. I do know that the mobile phones are banned in the college campus. I do know that, I should come with decent dress to the college. If I fail to do so suitable action may be taken against me. Date : Signature of the Candidate Place : DECLARATION BY THE PARENT / GUARDIAN 1. If there is any false information/fake certificate or any forgery in the Particulars/certificates/documents submitted by my ward to the authorities of MSRIT/University, my ward's admission may at once be cancelled and necessary action may be taken 2. I agree to the applicant's admission to the Institution. I shall be responsible for the payment of all fees and charges.i shall be responsible for my ward's conduct and good behavior during the course for the entire period till he/she gets the degree. There is no necessity for MSRIT to inform further regarding these matters. Date : Signature of the Parent Place : OFFICE USE Admn.Sec.Verified by... to SIS No dt A/C.Sec Verified by...to SIS dt... Dated...Fee paid Rs... In charge Accounts Section Admitted to...year/sem... PRINCIPAL
Page No. 6 WELCOME TO FRESHERS FOR THE ACADEMIC YEAR 2016-2017 INSTRUCTIONS The following instructions are to be followed by you before filling the Application Form. according to it. Hence, you are requested to act upon 1. You are informed to keep sufficient number of copies of all the certificates including Admission Order before submitting the original certificates. Once Original certificates submitted will not be returned till the Admission is approved by the University. 2. You will require these certificates to apply for Scholarship/ Bank Loan/ Education Loan/Passport etc. Original documents will be returned to the candidate during the II/III Year UG / PG Courses only. 3. The students of both UG and PG courses, who are eligible for the Scholarship/Fee Concession (All types of scholarships) are hereby informed that the Government of India has introduced the new scheme of Direct cash transfer to the students. Hence, students are hereby informed to open a Savings bank A/c. (Vijaya Bank, MSRIT Branch) and Aadhar Card is Mandatory for availing the above benefits for the academic year 2016-2017. For further details, you may log on to website: www.dcekar.nic.in The PG Students who are Eligible for GATE Scholarship are required to open a Savings Bank A/c. in State Bank of India(SBI) in any branch and Aadhar Card is Mandatory. In case of students belongs to SC/ST Category are required to submit the Caste Certificate in English version only for availing the Direct Cash Transfer from AICTE. 4. If the candidate has obtained 90% and above in the qualifying examination (10+2) Exam, then you are eligible for merit scholarship. For details, please log on to National Scholarship Portal. 5. If the candidate belongs to SC/ST category and selected the seat through KEA/PGCET, they can collect the Application for Scholarship /Fee-reimbursement which is available in the Admission & Scholarship Section. The candidate is required to submit the duly filled in Application with required attested copies of certificates to Admission Section within the stipulated date every year during the month of August/September. Late application will not be accepted under any circumstances. 6. If the candidate belongs to SC / ST Category and your parents Annual Income is below or equal to Rs.2,50,000/ - you have to register your name on the Social Welfare Department website. For any further information required, you may contact Social Welfare Department, The Taluk Social Welfare Officer, Bangalore North Taluk, No.704, 'A' Sector, 6th Main Cross, Yelahanka Upnagar, BANGALORE - 560 064 or Asst. Registrar, Admission & Scholarship Section. 7. In case of Non-receipt of Scholarship/Fee-reimbursement from Social Welfare Office / Director of Technical Education, Government of Karnataka before Commencement of even semester examination, the candidate shall have to pay the fee prescribed by our Institution before appearing to the even semester examination every year. 8. If you have selected through KEA-UGET/KEA-PGCET and belongs to CAT-1 (Parent Annual Income is less than or equal to 2 Lakhs) and for IIA,IIB,IIIA & IIIB ( parents annual income is less than or equal to Rs.1,00,000then youare eligible for Fee-concession. For further details, you may log on to http://karepass.cgg.gov.in 9. There is also a provision for scholarship / financial aid from Government Department / Public Sectors / Pvt. Trusts/Agencies for Merit Cum Poorer section of students, the list is announced on the notice board. Eligible candidates can apply when the
application is called for. 10. You are strongly advised and informed to see the Main and Departmental Notice Board regularly. Please note that late submission of Application with regard to Scholarship, Examination, Re-Registration etc., will result in losing the benefits which the candidate is eligible. 11. You are not allowed to use mobile inside the campus. 12. You are informed to come to college with decent dress. 13. Keep your belongings safely. The college authorities are not responsible for any loss. 14. You should not indulge in any anti-social activities. You should not indulge in any ragging. You must abide by the disciplinary norms stipulated by the college. If you violate these instructions, the college authorities have the right to take suitable disciplinary action against you. 15. In case the student discontinues the course, at any time AFTER the LAST DATE of admissions, the student will have to pay the fees for the remaining years of study and then obtain the original documents. 16. The classes for I Semester are likely to commence during First week of July / August (tentative). The exact date of commencement will be announced on the website: www.msrit.edu 17. Please read and understand the Autonomous Rules and Regulations which are currently in force and are available on website. In case of any doubt, please contact the Head of Department / Controller of Examinations / Registrar (Academic) / Principal. 18. You are informed that you have to pay the Annual tuition fee every year during the month of July / August by D.D. drawn in favour of RAMAIAH INSTITUTE OF TECHNOLOGY, BANGALORE or through RTGS to our SB Account 141201011008909 IFSC VIJB 0001412 MICR: 560029070. If you do not pay the fees within the stipulated date, you will not be allowed to attend the classes. In this regard, parents are requested to confirm from the Accounts Section, well in time, whether the fees are paid in time by their wards. This is particularly important if the parents are sending the fees through their wards so that they can avoid inconvenient to attend the classes / semester end examination by their wards. 19. Students who intend to change from Engineering course to other course on KEA(CET)/COMEDK allotment after the last date of admission, will have to pay full four years fees if they are leaving MSRIT for any other institution. 20. The newly admitted students are hereby informed to submit the Visvesvarya Technological University undertaking on a Judicial Stamp Paper of Rs.20/- and shall be sworn before notary and submit the same to the concerned department after the commencement of the classes without fail. We certify that we have read and understood the above instructions. We undertake to abide by the rules and regulations prescribed by the Institute's authorities from time to time. Name of the Student : Name of Parent : Class & Branch : Contact Number with STD Code : Quota / Category : Mobile Number : Signature of Student with Date Signature of Parent with Date
Page No. 8 ACKNOWLEDGEMENT KEA/COMEDK Hall Ticket No : KEA/COMEDK Ranks No : Received the following Original Certificates from Ms/Mr : Admitted to B.E in : Computer Science and Engineering Sem : Semester Year : Category : Sl.No. Documents Original Copies 1 NATA Score card for Architecture Course YES YES 2 Stamp size photos YES YES 3 10th Marks Sheet YES YES 4 12th Std. Marks Sheet/s. YES YES 5 Caster Certificate and Income Certificate (If claiming under SC/ST/1/2A/2B/3A/3B category) YES YES 6 Certificate from the indian embassy in proof of NRI status YES YES 7 KEA/COMEDK/UGCET Admin.Order 1+3 YES YES 8 Migration Certificate(if studied other than PUC of Kar.) YES YES 9 Passport and Visa Copy YES YES 10 Study Certificate 7/10 Years YES YES 11 Transfer Certificate / College Leaving Certificate YES YES Date : Signature
APPLICATION FOR TRANSFER CERTIFICATE To : Bangalore The Principal, Date : Through: The Principal RAMAIAH INSTITUTE OF TECHNOLOGY, Autonomous Institute, Affiliated to VTU, RAMAIAH INSTITUTE OF TECHNOLOGY, MSRIT Post Bangalore-560 054 Sir/Madam, SUB: Issue of Transfer Certificate I have been admitted to in at M.S. RAMAIAH INSTITUTE OF TECHNOLOGY MSRIT Post, Bangalore-560054 provisionally subject to the production of my Transfer Certificate. The particulars during my stay in your college are given below.i request you kindly to send my Original Transfer Certificate to The Principal, M.S. RAMAIAH INSTITUTE OF TECHNOLOGY (Autonomous Institute, Affiliated to VTU) MSRIT Post, Bangalore -560 054. If i have to pay arrears to the college, same may kindly be communicated to me. Name : Father name : Data of Birth : Class & year of Admission to your college: Class, Section & year in which I was studying at the time of leaving your college :... Subject / Degree Studied in the college Examination passed :... Reg.No :... Month/Year :... Date : Yours faithfully Place : Signature of the Candidate MSRIT/TC/No. RAMAIAH INSTITUTE OF TECHNOLOGY (Autonomous Institute, Affiliated to Visvesvaraya Technological University, Belgaum) M.S. RAMAIAH INSTITUTE OF TECHNOLOGY,MSRIT Post,Bangalore560 054. Date:... Forwarded to the Principal with a request to issue Transfer Certificate in person or send by Reg. Post at an early date.the Branch/Course may kindly be mentioned in the covering letter while sending the Transfer Certificate,to which admission is taken in this college by the candidate. PRINCIPAL