Tezpur Application Form PDF Details

Are you interested in studying at the prestigious Tezpur University? Are you looking for an overview of the application process, including what documents to submit with your application form? This blog post will provide you with all the information that you need to know in order to complete a successful application. Information regarding eligibility criteria and important dates associated with submitting your form are provided here as well, ensuring that each applicant has access to everything required for a smooth application process. Despite all the different steps involved, there is no need to be overwhelmed or frustrated by this initial stage; just take one step at a time and follow our advice and guidance. Good luck!

QuestionAnswer
Form NameTezpur Application Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesapply for prc online, prc application form 2020, apply prc online, prc online registration

Form Preview Example

For other than SC/ST

 

TEZPUR UNIVERSITY

 

 

 

 

 

 

For office use only

 

 

 

 

 

 

 

 

 

 

TEZPUR – 784028, ASSAM

 

 

Selected provisionally under

 

 

 

 

 

 

 

Gen/PWD/OBC (NCL)/KM**

 

 

(For B.Tech. Programme)

 

 

category

 

 

 

 

 

 

 

Paste one recent

 

 

 

 

 

 

 

 

 

 

passport size

 

 

 

 

 

colour photograph

 

Signature of Chairman

 

 

 

 

 

BSSC 2013

 

 

 

 

 

 

 

 

 

 

 

Admitted / provisionally

 

 

 

 

 

admitted

 

 

 

 

 

 

 

 

 

 

 

Signature of Controller of

 

 

APPLICATION FORM

 

Examinations

 

For admission to Autumn Semester 2013

 

 

 

 

 

(Read the prospectus carefully before filling in the form)

 

To be submitted to the Controller of Examinations on or before the specified date

 

1. Name in Full (Block Letters)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Are you willing to be considered under SSS

( For details, please refer to page31)

Yes

No

3. JEE (Main) Roll number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

year

 

JEE (Main)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

form no

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. Category

SC

ST

 

 

OBC(NCL)

 

OTHERS

5. Religion

……………

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. Nationality

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7. State of Domicile

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. Indicate if you belong to PWD category

YES

 

NO

(PWD stands for Persons

 

9. Gender

Male

Female

 

 

 

 

 

 

 

 

 

 

 

 

 

with Disability)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. Date of Birth (dd/mm/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11.(a) Father’s/Husband’s/Guardian’s

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name & his occupation

………………………………...………………………………………………

(b) Mother’s Name

………………………………………………………………………

& her occupation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12. Address for Correspondence

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

……………………………………………………………………………………

 

……………………………………………………………………………………

 

……………………………………………………………………………………

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pin:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E-mail : ………....………………………

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone No (with STD code)

......................................................................................

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. Permanent Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

……………………………………………………………………………………

 

……………………………………………………………………………………

 

……………………………………………………………………………………

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pin:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State : ………....………………………

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone No (with STD code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14. Choice of discipline

Priority 1

 

 

 

 

Priority 2

 

Priority 3

 

 

Priority 4

 

 

 

Priority 5

(CE / CSE / ECE / FET / ME)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Place:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.................................................

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Enclosures check list (tick whichever is applicable):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full signature of the candidate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

Data Sheet

Submission of filled-up Data Sheet along with Application Form is MANDATORY

1.

Name in Full (Block Letters)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

Permanent Address

……………………………………………………………………………………

 

 

 

 

……………………………………………………………………………………

 

 

……………………………………………………………………………………

 

 

 

 

 

 

 

 

 

 

 

 

Pin:

 

 

 

 

 

 

 

E-mail : ……….....……………………

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone No (with STD code)

 

 

 

 

 

 

 

 

 

 

 

 

3.

Local Guardian’s Name & Address

……………………………………………………………………………………

 

 

 

 

……………………………………………………………………………………

 

 

……………………………………………………………………………………

 

 

 

 

 

 

Pin:

 

 

 

 

 

 

 

E-mail : ……….....……………………

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone No (with STD code)

 

 

 

 

 

 

 

 

 

 

 

 

4.

Hostel accommodation

Required

Not Required

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Educational Qualifications starting from 10th standard or equivalent:

 

Board /

Year of

Class /

Subjects taken (including

% of Marks /

 

Exam. Passed

University /

Grade/

Remarks

passing

Honours / Major, if any)

Eqv. Grade

 

Institute

Division

 

 

 

 

 

 

HSLC(10th std)

 

 

 

 

 

 

 

 

 

 

 

 

 

10+2 std.

 

 

 

 

 

 

 

 

 

 

 

 

 

Degree*

 

 

 

 

 

 

 

 

 

 

 

 

 

PG**

 

 

 

 

 

 

 

 

 

 

 

 

 

Others

 

 

 

 

 

 

 

 

 

 

 

 

 

*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]

:

 

 

If yes, furnish the details

: …………………………………………………………

8.

Specialized academic training (if any)

:

 

 

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 Vice-Chancellor and the authorities of the Univer- sity who may be vested with such power under the Act, Statutes, Ordinances and the Rules that have been framed there un- der by the University.

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: .............................................

.................................................

Place:

 

Full signature of the candidate

 

 

 

Acknowledgement for receipt of Application form

Form No

 

 

 

(Only for B.Tech. candidates )

 

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

 

To :

 

...........................................................................

 

...........................................................................

 

Tezpur University

Sender’s name & address :

Napaam, Tezpur

 

Pin : 784 028

.......................................................................

Dist : Sonitpur, Assam

.......................................................................

 

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