Name in Full (Capital Letters) as per CMAT Score Card. 2. Gender : ... Note : (1)
Processing Fees (non-refundable) by DD of Amount INR 500/750 as applicable.
APPLICATION FEE INR 500/- [NON-REFUNDABLE] MBA/MCA APPLICATION FEE INR 750/- [NON-REFUNDABLE] MBA+MCA
COMMISSIONERATE OF TECHNICAL EDUCATION, GUJARAT STATE Admission Committee for Professional Courses (ACPC)
(Constituted under Section 4 of the Gujarat Professional Technical Educational Colleges or Institutions (Regulation of Admission and Fixation of Fees) Act. 2007 (Guj.2 of 2008)
First Floor, ACPC Building, L. D. College of Engineering Campus, Navrangpura, Ahmedabad-380 015, Gujarat, India
APPLICATION FORM FOR ADMISSION TO MBA/MCA IN GUJARAT STATE FOR CANDIDATES WHO HAVE PASSED HSC & GRADUATION BOTH FROM OUTSIDE GUJARAT AND APPEARED IN CMAT 2013. (Select appropriate check box with )
[A] PERSONAL INFORMATION OF THE CANDIDATE 1.
Name in Full (Capital Letters) as per CMAT Score Card
2.
Gender :
3.
Date of Birth :
4.
Place of Birth : CITY
Male
Affix Recent Passport Size Photograph of candidate with Signature
Female –
–
[DD–MM–YYYY] STATE
COUNTRY
PIN/ZIP
5.
Nationality:
6.
Contact Address of Candidate : Address for Correspondence
Phone/Mobile No. with STD Code
Fax No. E-mail ID
7.
Name of Parent / Guardian :
8.
Relationship with Candidate :
[B] EXAMINATION DETAILS : 1.
SSC or Equivalent Examination : Name of Examination
Name of School
Marks in Name & Place of Month & Year Total Marks* Mathematics Board with of Passing Seat No. Obtained Out of Obtained Out of %
*Incase of grade points, insert equivalent %.
[1]
2.
HSC or Equivalent Examination : Name of Examination
Name and Location of School
Name & Place of Board with Seat No.
Month & Year of Passing
Total Marks* Obtained Out of
%
*Incase of grade points, insert equivalent %.
3.
Details of Graduation Examination : Name of Degree Examination
4.
Name & Location of Institute/ University
Month & Year of Passing
Incase of SPI/CPI / CGPA
Result as per Final Year Marksheet Obtained
Out of
%
Grade
Base
Equivalent %
Details of Entrances Examination (CMET) : • CMAT Roll No.
: ___________________ (Corresponding to max. score)
• CMAT Score (Total) : ___________________ • Sectionwise Score : Section–I (QT & DI) : ________
Section–III (LC) : ________
Section–II (LR)
Section–IV (GA) : ________
: ________
[C] PARTICULARS OF FEE
(Non Refundable)
1.
Amount INR :
3.
DD Date :
2.
DD No. :
4.
Bank Name :
Note :
(1) Processing Fees (non-refundable) by DD of Amount INR 500/750 as applicable. (2) DD should be in favour of “Member Secretary, ACPC” payable at Ahmedabad.
[D] DECLARATION BY CANDIDATE : I do hereby declare that all the paritculars indicated above are true and correct to the best of my knowledge and belief. I have read the Admission Rules and Information Brochure, and I shall abide by all the rules and other terms and conditions for admission. I understand that my admission will be provisional and in the event of my candidature being found ineligible at a later date, I will be denied admission and, if already admitted, my admission will stand cancelled. I also udnerstand that the decision of the Admission Committee regarding my admission shall be final and I shall be liable by its decision. I am also aware that ragging is banned and if, found guilty, I shall be liable for punishments under the rules. I abide to pay the fees as determined by the Fee Regulatory Committee / State Govt.
Date :
Singature of Candidate
Place : Singature of Parent / Guardian Note : Attach self-attested copies of all the necessary documents / testimonials with this form.
INSTRUCTIONS 1. On receipt of application with requisite registration fee at ACPC within the time limit, unique PIN, User ID and a password will be send to the candidate on his / her email ID or by SMS on Mobile mentioned in the application form latest by 8-7-2013. 2. Candidate has to register online through website www.gujacpc.nic.in 3. After choice filling, admission will be allotted based on your merit and choices. After allotment, for confirmation of his admission he has to report at ACPC with “Information Letter” and bank fee challan and all original documents. 4. After first login with the password provided by ACPC the candidate should immediately change the password for security point of view.
