The document appears to be an application form for admission to postgraduate programs (Ph.D., M.Des., M.S.(Research), and M.Tech.) at the Indian Institute of Technology Delhi. It requests information such as the applicant's personal details, educational qualifications, GATE/CEED scores, work experience, proposed area of research, department/program choices, and payment details. The form also includes instructions for submission of additional documents and notes that incomplete applications may be provisionally accepted pending submission of required documents by specified dates.
1. Downloaded Form Ph.D.
(Closing Date 14 April, 2011)
Paste your
INDIAN INSTITUTE OF TECHNOLOGY DELHI Unattested
Application Form for Admission to Ph.D. Programme Photograph
Please read the instructions given in the Information Brochure BEFORE you fill up the form
Visit : http://www.iitd.ac.in/pgadmission for details)
Tick (✓) the relevant box wherever provided.
Full time with Assistantship Employed Candidates (No assistantship)
Source of Assistantship Sponsored (Full-time) Part -time
C A T E G O R Y
INSTITUTE CSIR
M.Tech. Degree
OR
Experience Experience
GATE Discipline Year GATE Score GATE Marks (%)
UGC NET
Years ..................... Years .....................
................ ................ ................ ................
Tick GENERAL OBC SC ST PH
whichever
is applicable
(Non-Creamy Layer)
Department / Centre Ph.D. Code
(Write here name of only (See Annexure-I
CHOICE
ONE Department/Centre of Information Brochure)
you are appying to) .....................................................................................................
Proposed Area of Research
Name (in CAPITAL)
Gender / D.O.B. Male Female Date-of-birth (dd/mm/yyyy)
Father’s Name
PERSONAL
Mothers Name
Address for
Correspondence
PIN: Tel No. with STD Code
Email : Mobile No. :
Permanent
Address
PIN: Tel No. with STD Code
Email : Mobile No. :
Qualifying Exam ................................ Duration of the course (Years) .................... Discipline .......................................
Year of Passing .................................Name of University / Institute : ............................................................................
QUALIFYING DEGREE
Marks Obtained Max. Marks Marks Obtained Max. Marks
CGPA/ Year 1 Semester I ................. ................. Semester II ................. .................
Marks
Year 2 Semester I ................. ................. Semester II ................. .................
Obtained
Year 3 Semester I ................. ................. Semester II ................. .................
Year 4 Semester I ................. ................. Semester II ................. .................
CGPA Secured out of OR Aggregate % of marks (of all years/semesters)
Details of Marks secured in the Examinations other than qualifying examination
PREV. ACAD.REC.
Exam./ Discipline Institute/ Year of % Marks/ Rank in Class/
Degree University Passing CGPA University
10+2/Equivalent
B.Sc.
M.Sc./B.Tech
Other (specify)
2. EXPERIENCE IF ANY
Experience (From date to date) Designation Organisation with address
List of Publications (Attach Separate Sheet if required)
Mode of obtaining the Form From Bank By Post Downloaded
PAYMENT
Payment details of Bank Draft No. : Amount Rs.
application form
Date :
Drawn on :
Have you ever studied and discontinued your studies at IIT Delhi ? YES NO
If YES, give Entry number and the particulars of the programme earlier
attended and the reason for discontinuation.
Date____________ (Signature of the Candidate)
FOR DEPARTMENT/CENTRE’S USE
FOR P.G. SECTION USE ONLY
(Recommendations/observations of the office)
The candidate may be provisionally admitted/not admitted subject to the following :
1) Submission of attested copies of the qualifying degree certificate and marks sheet showing the required
% of marks/CGPA by 21.7.2011/ 31.10.2011.
2) Submission of proof from the University/Head of the Institution of having appeared/passed in the qualifying
Degree Examination by 21.7.2011.
3) Submission of GATE Score Card/CSIR/NET award letter (in original) by 21.7.2011.
4) Submission of relieving certificate from Employer by 21.7.2011.
DR/AR (PGS&R) Signature of OS (PGS&R)
3. Downloaded Form M.Des.
(Closing Date 26 April, 2011)
Paste your
INDIAN INSTITUTE OF TECHNOLOGY DELHI Unattested
Photograph
Application Form for Admission to M.Des. Programme
Please read the instructions given in the Information Brochure BEFORE you fill up the form
Visit : http://www.iitd.ac.in/pgadmission for details)
Tick (✓) the relevant box wherever provided.
Full time with Assistantship
Employed Candidates (No assistantship)
C A T E G O R Y
CEED Percentile Year Discipline Sponsored (Full-time)
Experience
.................... ............. .........................................
Years ......................
GENERAL OBC SC ST PH
Tick
whichever
is applicable
(Non-Creamy Layer)
Name (in CAPITAL)
Gender / D.O.B. Male Female Date-of-birth (dd/mm/yyyy)
Father’s Name
PERSONAL
Mothers Name
Address for
Correspondence
PIN: Tel No. with STD Code
Email : Mobile No. :
Permanent
Address
PIN: Tel No. with STD Code
Email : Mobile No. :
Qualifying Exam ................................ Duration of the course (Years) .................... Discipline .......................................
Year of Passing .................................Name of University / Institute : ............................................................................
DEGREE
Marks Obtained Max. Marks Marks Obtained Max. Marks
CGPA/ Year 1 Semester I ................. ................. Semester II ................. .................
Marks
QUALIFYING
Year 2 Semester I ................. ................. Semester II ................. .................
Obtained
Year 3 Semester I ................. ................. Semester II ................. .................
Year 4 Semester I ................. ................. Semester II ................. .................
CGPA Secured out of OR Aggregate % of marks (of all years/semesters)
Details of Marks secured in the Examinations other than qualifying examination
PREV. ACAD.REC.
Exam./ Discipline Institute/ Year of % Marks/ Rank in Class/
Degree University Passing CGPA University
10+2/Equivalent
B.Sc.
M.Sc./B.Tech
Other (specify)
4. EXPERIENCE IF ANY
Experience (From date to date) Designation Organisation with address
Mode of obtaining the Form From Bank By Post Downloaded
PAYMENT
Payment details of Bank Draft No. : Amount Rs.
application form
Date :
Drawn on :
Have you ever studied and discontinued your studies at IIT Delhi ? YES NO
If YES, give Entry number and the particulars of the programme earlier
attended and the reason for discontinuation.
Date____________ (Signature of the Candidate)
FOR DEPARTMENT/CENTRE’S USE
FOR P.G. SECTION USE ONLY
(Recommendations/observations of the office)
The candidate may be provisionally admitted/not admitted subject to the following :
1) Submission of attested copies of the qualifying degree certificate and marks sheet showing the required
% of marks/CGPA by 21.7.2011/ 31.10.2011.
2) Submission of proof from the University/Head of the Institution of having appeared/passed in the qualifying
Degree Examination by 21.7.2011.
3) Submission of CEED Score / Percentile Card (in original) by 21.7.2011.
4) Submission of relieving certificate from Employer by 21.7.2011.
DR/AR (PGS&R) Signature of OS (PGS&R)
5. Downloaded Form M.S. (Research)
(Closing Date 14 April, 2011)
Paste your
INDIAN INSTITUTE OF TECHNOLOGY DELHI Unattested
Photograph
Application Form for Admission to M.S. (R) Programme
Please read the instructions given in the Information Brochure BEFORE you fill up the form
Visit : http://www.iitd.ac.in/pgadmission for details)
Tick (✓) the relevant box wherever provided.
Employed Candidates (No assistantship)
C A T E G O R Y
Full time with Assistantship
GATE Discipline Year GATE Score GATE Marks (%) Sponsored (Full-time) Part -time
Experience Experience
................ ................ ................ ................ Years ...................... Years .........................
GENERAL OBC SC ST PH
Tick
whichever
is applicable
(Non-Creamy Layer)
PROGRAMME
M.S.(R) Code
Depatment Name ..................................................................................................................
Name (in CAPITAL)
Gender / D.O.B. Male Female Date-of-birth (dd/mm/yyyy)
Father’s Name
PERSONAL
Mothers Name
Address for
Correspondence
PIN: Tel No. with STD Code
Email : Mobile No. :
Permanent
Address
PIN: Tel No. with STD Code
Email : Mobile No. :
Qualifying Exam ................................ Duration of the course (Years) .................... Discipline .......................................
Year of Passing .................................Name of University / Institute : ............................................................................
QUALIFYING DEGREE
Marks Obtained Max. Marks Marks Obtained Max. Marks
CGPA/ Year 1 Semester I ................. ................. Semester II ................. .................
Marks
Year 2 Semester I ................. ................. Semester II ................. .................
Obtained
Year 3 Semester I ................. ................. Semester II ................. .................
Year 4 Semester I ................. ................. Semester II ................. .................
CGPA Secured out of OR Aggregate % of marks (of all years/semesters)
Details of Marks secured in the Examinations other than qualifying examination
PREV. ACAD.REC.
Exam./ Discipline Institute/ Year of % Marks/ Rank in Class/
Degree University Passing CGPA University
10+2/Equivalent
B.Sc.
M.Sc./B.Tech
Other (specify)
6. EXPERIENCE IF ANY
Experience (From date to date) Designation Organisation with address
Mode of obtaining the Form From Bank By Post Downloaded
PAYMENT
Payment details of Bank Draft No. : Amount Rs.
application form
Date :
Drawn on :
Have you ever studied and discontinued your studies at IIT Delhi ? YES NO
If YES, give Entry number and the particulars of the programme earlier
attended and the reason for discontinuation.
Date____________ (Signature of the Candidate)
FOR DEPARTMENT/CENTRE’S USE
FOR P.G. SECTION USE ONLY
(Recommendations/observations of the office)
The candidate may be provisionally admitted/not admitted subject to the following :
1) Submission of attested copies of the qualifying degree certificate and marks sheet showing the required
% of marks/CGPA by 21.7.2011/ 31.10.2011.
2) Submission of proof from the University/Head of the Institution of having appeared/passed in the qualifying
Degree Examination by 21.7.2011.
3) Submission of GATE Score Card (in original) by 21.7.2011.
4) Submission of relieving certificate from Employer by 21.7.2011.
DR/AR (PGS&R) Signature of OS (PGS&R)
7. Downloaded Form M.Tech.
(Closing Date 14 April, 2011)
Paste your
INDIAN INSTITUTE OF TECHNOLOGY DELHI Unattested
Photograph
Application Form for Admission to M.Tech. Programmes
Please read the instructions given in the Information Brochure BEFORE you fill up the form
Visit : http://www.iitd.ac.in/pgadmission for details)
Tick (✓) the relevant box wherever provided.
Employed Candidates (No assistantship)
C A T E G O R Y
Full time with Assistantship
GATE Discipline Year GATE Score GATE Marks (%) Sponsored (Full-time) Part -time
Experience Experience
................ ................ ................ ................ Years ...................... Years .........................
GENERAL OBC SC ST PH
Tick
whichever
is applicable
(Non-Creamy Layer)
Write the name of the Depatment/Centre (in case
of Deptt/Centre M.Tech Programmes)
PROGRAMME
OR
The name of the Interdisciplinary M.Tech. Prog.
Note : Only one of these options is allowed in one form ..................................................................................................................
Candidate can indicate upto four preferences using Option 1 Option 2 Option 3 Option 4
M.Tech. programmes codes in the same deptt. /
centre.
In case of application to interdisciplinary M.Tech
programme, only option 1 box to be filled with
the desired IDP Code
Name (in CAPITAL)
Gender / D.O.B. Male Female Date-of-birth (dd/mm/yyyy)
Father’s Name
PERSONAL
Mothers Name
Address for
Correspondence
PIN: Tel No. with STD Code
Email : Mobile No. :
Permanent
Address
PIN: Tel No. with STD Code
Email : Mobile No. :
Qualifying Exam ................................ Duration of the course (Years) .................... Discipline .......................................
Year of Passing .................................Name of University / Institute : ............................................................................
QUALIFYING DEGREE
Marks Obtained Max. Marks Marks Obtained Max. Marks
CGPA/ Year 1 Semester I ................. ................. Semester II ................. .................
Marks
Year 2 Semester I ................. ................. Semester II ................. .................
Obtained
Year 3 Semester I ................. ................. Semester II ................. .................
Year 4 Semester I ................. ................. Semester II ................. .................
CGPA Secured out of OR Aggregate % of marks (of all years/semesters)
Details of Marks secured in the Examinations other than qualifying examination
PREV. ACAD.REC.
Exam./ Discipline Institute/ Year of % Marks/ Rank in Class/
Degree University Passing CGPA University
10+2/Equivalent
B.Sc.
M.Sc./B.Tech
Other (specify)
8. EXPERIENCE IF ANY
Experience (From date to date) Designation Organisation with address
Mode of obtaining the Form From Bank By Post Downloaded
PAYMENT
Payment details of Bank Draft No. : Amount Rs.
application form
Date :
Drawn on :
Have you ever studied and discontinued your studies at IIT Delhi ? YES NO
If YES, give Entry number and the particulars of the programme earlier
attended and the reason for discontinuation.
Date____________ (Signature of the Candidate)
FOR DEPARTMENT/CENTRE’S USE
FOR P.G. SECTION USE ONLY
(Recommendations/observations of the office)
The candidate may be provisionally admitted/not admitted subject to the following :
1) Submission of attested copies of the qualifying degree certificate and marks sheet showing the required
% of marks/CGPA by 21.7.2011/ 31.10.2011.
2) Submission of proof from the University/Head of the Institution of having appeared/passed in the qualifying
Degree Examination by 21.7.2011.
3) Submission of GATE Score Card (in original) by 21.7.2011.
4) Submission of relieving certificate from Employer by 21.7.2011.
DR/AR (PGS&R) Signature of OS (PGS&R)