The Tezpur University Application Form signifies a vital step for aspirants seeking admission into the prestigious B.Tech program for the Autumn Semester of 2013. Located in Tezpur, Assam, the form is tailored for various categories of candidates, excluding SC/ST but providing provisions for Gen/PWD/OBC (NCL)/KM categories. The meticulously designed form requires a recent passport-size color photograph and encompasses detailed sections for personal and academic information. Candidates are prompted to divulge their full name, willingness to be considered under special schemes, JEE (Main) roll number, and specific personal details including category, religion, nationality, domicile state, disability status, gender, and birthdate. Moreover, it delves into the educational qualifications of the applicants, starting from the 10th standard onwards, and highlights any academic distinctions or specialized training the candidate might possess. Additionally, the form includes a section for extracurricular achievements and requires a declaration from the candidate to abide by the university’s rules and regulations. Accompanied by a checklist for necessary enclosures such as bank draft, JEE (Main) admit card photocopy, and attested copy of PRC (Permanent Residence Certificate), the application ensures all pertinent information and documents are submitted accurately and completely. This application process, underscored by its thoroughness, underscores Tezpur University’s commitment to attracting and evaluating a diverse and talented pool of applicants for its B.Tech program.
| Question | Answer |
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| Form Name | Tezpur Application Form |
| Form Length | 3 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 45 sec |
| Other names | apply for prc online, prc application form 2020, apply prc online, prc online registration |
For other than SC/ST |
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TEZPUR UNIVERSITY |
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For office use only |
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TEZPUR – 784028, ASSAM |
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Selected provisionally under |
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Gen/PWD/OBC (NCL)/KM** |
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(For B.Tech. Programme) |
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category |
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Paste one recent |
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passport size |
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colour photograph |
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Signature of Chairman |
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BSSC 2013 |
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Admitted / provisionally |
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admitted |
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Signature of Controller of |
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APPLICATION FORM |
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Examinations |
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For admission to Autumn Semester 2013 |
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(Read the prospectus carefully before filling in the form) |
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To be submitted to the Controller of Examinations on or before the specified date |
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1. Name in Full (Block Letters) |
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2. Are you willing to be considered under SSS
( For details, please refer to page31)
Yes
No
3. JEE (Main) Roll number |
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year |
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JEE (Main) |
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form no |
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4. Category |
SC |
ST |
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OBC(NCL) |
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OTHERS |
5. Religion |
…………… |
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6. Nationality |
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7. State of Domicile |
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8. Indicate if you belong to PWD category |
YES |
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(PWD stands for Persons |
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9. Gender |
Male |
Female |
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with Disability) |
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10. Date of Birth (dd/mm/yyyy) |
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11.(a) Father’s/Husband’s/Guardian’s |
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Name & his occupation |
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(b) Mother’s Name |
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& her occupation |
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12. Address for Correspondence |
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…………………………………………………………………………………… |
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Pin: |
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Phone No (with STD code) |
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13. Permanent Address |
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…………………………………………………………………………………… |
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Pin: |
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State : ………....……………………… |
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Phone No (with STD code) |
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14. Choice of discipline |
Priority 1 |
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Priority 2 |
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Priority 3 |
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Priority 4 |
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Priority 5 |
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(CE / CSE / ECE / FET / ME) |
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Date: |
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Place: |
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................................................. |
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Enclosures check list (tick whichever is applicable): |
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Full signature of the candidate |
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1.Bank Draft (if the form is downloaded)
2.Photocopy of the JEE (Main) admit card
3.Attested copy of PRC.
Note: The applicant is responsible for authenticity of the information provided in the application. In case of any discrepancy, the candidature will be cancelled.
TEZPUR UNIVERSITY |
Form No…….........…….. |
TEZPUR – 784028, ASSAM |
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Data Sheet
Submission of
1. |
Name in Full (Block Letters) |
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2. |
Permanent Address |
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Pin: |
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Phone No (with STD code) |
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3. |
Local Guardian’s Name & Address |
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Pin: |
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Phone No (with STD code) |
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4. |
Hostel accommodation |
Required |
Not Required |
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5. Educational Qualifications starting from 10th standard or equivalent:
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Board / |
Year of |
Class / |
Subjects taken (including |
% of Marks / |
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Exam. Passed |
University / |
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Remarks |
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passing |
Honours / Major, if any) |
Eqv. Grade |
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Institute |
Division |
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HSLC(10th std) |
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10+2 std. |
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Degree* |
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PG** |
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Others |
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*BSc / BA / BVSc / BE etc; ** MSc / MA / MTech / MBA / MCA : Qualifying degree appearing candidate should provide the marks / grade of their penultimate examination.
6.Academic Distinction / Medals / Prizes, if any :
7. |
Were you |
a) Debarred from any examination(s)? [Y / N] |
: b) Punished for misconduct? [Y / N] |
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If yes, furnish the details |
: ………………………………………………………… |
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8. |
Specialized academic training (if any) |
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9.Any other information (NCC / NSS / Sports / Cultural activity / Research publication etc.) you wish to add that will support your candidature for the Programme (may attach extra sheet, if required) :
10.Declaration to be signed by the candidate
I declare that I shall abide by the Statutes, Ordinances, Rules, and Orders etc. of the University that will be in force from time to time. I will submit myself to the disciplinary jurisdiction of the
I also declare that the information given above is true and complete to the best of my knowledge and belief, and if any of it is found to be incorrect, my admission shall liable to be cancelled and I shall be liable to such disciplinary action as may be decided by the University.
Date: .............................................
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Full signature of the candidate |
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Acknowledgement for receipt of Application form |
Form No |
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(Only for B.Tech. candidates ) |
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Mr./Miss/ Mrs. ………...................................….............………….., your Application for admission into …......………..........…
programme of ……….....……………………. Department of Tezpur university has been received by the concerned authority.
NB: Candidate must fill up this form.
Format for Envelope
Applied for |
Programme |
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To : |
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........................................................................... |
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Tezpur University |
Sender’s name & address : |
Napaam, Tezpur |
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Pin : 784 028 |
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Dist : Sonitpur, Assam |
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