BHARTI VIDYAPEETH ENGINEERING COLLEGE IP(GGSIPU) MANAGEMENT QUOTA ADMISSIONON @MR IPU SPECIALIST CONTACT FOR ADMISSION, 2009 2010 2011 2012 2013 2014 2015 2016 2018 2019 2020

AMITY SCHOOL OF ENGINEERING & TECHNOLOGYAn Institution of Ritnand Balved Education Foundation (RBEF)Affiliated to Guru Gobind Singh Indraprastha University (GGSIPU), Delhi580, Bijwasan, Delhi-Palam Vihar Road (Near IGI Airport), New Delhi - 110061Tel. No. 28062106, 28061487 Fax: 28061821 E-mail: aset.newdelhi@amity.eduAffix PhotographApplication form for Management Seats for B.Tech (LateralEntry) Programme of Amity School of Engineering &Technology for the Academic Batch 2014-20171. Name of the programme applied for B.Tech ___________2. GGSIPU* CET ROLL NO. ___________ 3. GGSIPU CET RANK _________* Guru Gobind Singh Indraprastha University (GGSIPU)4. CANDIDATE’S 1st NAME (in capitals) MIDDLE NAME SURNAME5. NAME OF FATHER (in capitals) MIDDLE NAME SURNAME6. NAME OF MOTHER (in capitals) MIDDLE NAME SURNAME7. COMPLETE POSTAL ADDRESS (in capitals) (Do not repeat name)STATE PIN CODETELEPHONE/MOBILEE-MAIL ………………………8. DATE OF BIRTH (in Christian era)DAY MONTH YEAR9. SEX (Tick √ in appropriate box) M F10. DETAILS OF QUALIFYING EXAMINATION PASSED:Exam Board /UniversityRoll No.& YearName / Addressof SchoolInstitutionattendedSubjects studied% ofmarksscored(upto 2decimal)% marksinaggregateDiploma(Engg. &Tech.)orGraduation(B.Sc.)11. DECLARATIONI hereby solemnly and sincerely affirm that I fulfill the eligibility conditions prescribed bythe GGS IP University and that the statements made and information furnished by me in thisapplication form are true and correct. Further I will produce all the required documents asrequired during GGS IP University Counseling including Original Admit Card. Also I have notwithheld any information. If it is found that any information furnished herein is fraudulent,incorrect or untrue in material particulars, I realize that I am liable to prosecution and that theadmission to the programme is liable to be cancelled.Date _______________ Signature of the Candidate ____________________I have carefully read and verified the information furnished by me as parent and by myson/daughter/ward and affirm that it is true and correct.Date _______________ Signature of the Father/Mother _________________